HIV Discrimination

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HIV/AIDS | Discrimination | Connecticut

Does Connecticut have laws protecting people with HIV from discrimination?

Yes, Connecticut has enacted anti-discrimination laws protecting people with HIV from discrimination in employment, housing, public accommodations, and credit. In addition, there are a number of federal laws that protect people from discrimination based on their HIV status.

Qui est protégé par ces lois anti-discrimination ?

• Les personnes atteintes du SIDA ou séropositives, même si elles sont asymptomatiques et ne présentent aucun signe extérieur ou manifeste de maladie.
• Under the ADA, but not Connecticut law, persons who are regarded or perceived as having HIV.
• Under the ADA, but not Connecticut law, a person who does not have HIV, but who “associates” with a person with HIV — such as friends, lovers, spouses, roommates, business associates, advocates, and caregivers of a person or persons with HIV.

Quelles lois protègent les personnes vivant avec le VIH contre la discrimination dans l’emploi ?

People who are HIV-positive or who have AIDS are protected from employment discrimination under both Connecticut Human Rights Law (Conn. Gen. Stat. sec. 46a-60) and the federal Americans with Disabilities Act (ADA). Both of these statutes prohibit discrimination in employment on the basis of a person’s disability. The Connecticut law covers employers with 3 or more employees in the United States; the ADA covers employers with fifteen or more employees.

The Rehabilitation Act of 1973 prohibits discrimination on the basis of disability in programs conducted by federal agencies, in programs receiving federal financial assistance, in federal employment and in the employment practices of federal contractors.

For more information about employment discrimination in Connecticut, see: Discrimination | Employment | Connecticut 

Qu’interdisent ces lois anti-discrimination ?

An employer may not take adverse action against an applicant or employee simply on the basis that the person has a disability such as HIV or AIDS. This means that an employer may not terminate, refuse to hire, rehire, promote, or otherwise discriminate in the terms or conditions of employment, based on the fact that a person is HIV-positive or has AIDS.

L’accent est mis ici sur la question de savoir si une personne atteinte du sida ou du VIH a été traitée différemment des autres candidats ou employés dans des situations similaires.

Voici des exemples de discrimination illégale :

• Un employeur ne peut pas refuser d’embaucher une personne atteinte du VIH par crainte que le VIH soit transmis à d’autres employés ou à des clients.
• Un employeur ne peut pas refuser d’embaucher ou de prendre une décision d’emploi en se basant sur la possibilité, ou même la probabilité, qu’une personne tombe malade et ne soit plus en mesure d’effectuer le travail à l’avenir.
• Un employeur ne peut pas refuser d’embaucher une personne parce que cela augmenterait les primes d’assurance maladie ou d’assurance contre les accidents du travail.

Quelles questions un employeur peut-il poser sur la santé d’un employé au cours du processus de candidature et d’entretien ?

Under the ADA, prior to employment, an employer cannot ask questions that are aimed at determining whether an employee has a disability. Examples of prohibited pre-employment questions are:

• Avez-vous déjà été hospitalisé ou sous les soins d’un médecin ?
• Avez-vous déjà bénéficié d’une indemnisation des accidents du travail ou reçu des prestations d’invalidité ?
• Quels médicaments prenez-vous?

Après une offre d'emploi, un employeur peut-il exiger un examen médical ? Quelles sont les directives applicables ?

If an employer has 15 or more employees, they must comply with the ADA. After a conditional offer of employment, an employer may require a physical examination or medical history. The job offer, however, may not be withdrawn unless the results demonstrate that the person cannot perform the essential functions of the job with or without reasonable accommodation. The same medical inquiries must be made of each person in the same job category. In addition, the physical examination and medical history records must be segregated from personnel records, and there are strict confidentiality protections.

After employment has begun, the ADA permits an employer to only require a physical examination if it is job-related and consistent with business necessity.

Comment les tribunaux ont-ils répondu aux craintes selon lesquelles les professionnels de la santé qui pratiquent des interventions invasives, comme les chirurgiens, transmettent le VIH aux patients ?

Le risque de transmission du VIH d'un professionnel de santé à un patient est considéré comme si faible qu'il est proche de zéro. Néanmoins, lorsque des hôpitaux ont cherché à restreindre ou à supprimer les privilèges de professionnels de santé séropositifs pratiquant des interventions invasives, les tribunaux ont réagi avec une crainte extrême et ont insisté sur une norme impossible à respecter : le « risque zéro ». Par conséquent, les rares tribunaux qui ont examiné cette question en vertu de l'ADA ont confirmé ces suppressions.

The employment provisions in the ADA provide that an employee is not qualified to perform the job if they pose a “direct threat to the health or safety of others.” To determine whether an employee poses a “direct threat,” a court analyzes:

• La nature, la durée et la gravité du risque ;
• La probabilité du risque ; et
• Si le risque peut être éliminé par un aménagement raisonnable.

However, in the case of HIV-positive health care workers, courts have ignored the extremely remote probability of the risk and focused on the nature, duration and severity of the risk. The following excerpt from a recent case is typical of courts’ approach:

“We hold that Dr. Doe does pose a significant risk to the health and safety of his patients that cannot be eliminated by reasonable accommodation. Although there may presently be no documented case of surgeon-to-patient transmission, such transmission clearly is possible. And, the risk of percutaneous injury can never be eliminated through reasonable accommodation. Thus, even if Dr. Doe takes extra precautions… some measure of risk will always exist…” (Doe v. University of Maryland Medical System Corporation, 50 F.3d 1261 (4ème Cir. 1995)).

It is important to note that only a small number of courts have addressed the rights of HIV-positive health care workers. The AIDS Law Project believes that these cases have been incorrectly decided and are inconsistent with the intent of Congress in passing the ADA. Because of the unsettled nature of the law in this area, a health care worker who is confronted with potential employment discrimination should consult a lawyer or public health advocate.

Évaluation de la discrimination par un employeur

Bien qu’il puisse être utile de consulter un avocat, les étapes suivantes peuvent être utiles pour commencer à considérer et à évaluer un problème potentiel de discrimination à l’emploi.

1. Consider the difference between unfairness and illegal discrimination. The bottom line of employment law is that an employee can be fired for a good reason, bad reason, or no reason at all. A person can be legally fired for a lot of reasons, including a bad “personality match.” What they cannot be fired for is a discriminatory reason specifically outlawed by a statute.
2. In order to prove a discrimination claim (i.e., that you were fired, demoted, etc. because of discrimination and not because of some legitimate reason), you must be able to show the following:
   • L’employeur savait ou a découvert que vous étiez séropositif ou atteint du sida ;
   • Vous étiez qualifié pour exécuter les fonctions essentielles du poste avec ou sans aménagement raisonnable ; et
   • Des mesures défavorables ont été prises à votre encontre en raison de votre statut VIH ou SIDA et la raison invoquée par l’employeur pour justifier ces mesures défavorables est fausse.

3. If your employer knows that you have HIV or AIDS, identify exactly who knows, how they know, and when they found out. If you have not told your employer, is there any other way the employer would know or suspect your HIV status?
4. Consider the reasons why you believe that you are being treated differently because of HIV status, including the following areas:
   • D’autres employés dans des situations similaires ont-ils été traités différemment ou de la même manière ?
   • Votre employeur a-t-il respecté ses politiques en matière de personnel ?
   • Le traitement défavorable a-t-il commencé peu de temps après que l’employeur a appris votre statut VIH ?
   • Avez-vous été absent du travail en raison d’une maladie pendant une période donnée et le traitement défavorable a-t-il commencé dès votre retour au travail ?
   • Quelle sera la version des faits de votre employeur ? Comment prouverez-vous que sa version est fausse ?

5. Do you have any difficulty fulfilling the duties of your job because of any HIV-related health or medical issue? Does your condition prevent full-time work, or require time off for medical appointments, lighter duties or a less stressful position? You might want to try brainstorming to create a reasonable accommodation that you can propose to your employer. Here are some points to consider:
   • Comment fonctionne l'entreprise et comment fonctionnerait l'hébergement en pratique ?
   • Mettez-vous à la place de votre supérieur. Quelles objections pourraient être soulevées face à l'aménagement raisonnable demandé ? Par exemple, si vous devez partir à une heure précise pour des rendez-vous médicaux, qui assurera votre remplacement ?

What laws prohibit discrimination in housing?

It is illegal under both Connecticut law (Conn. Gen. Stat. sec. 46a-64c) and the National Fair Housing Amendments of 1989, to discriminate in the sale or rental of housing on the basis of HIV status. A person cannot be evicted from an apartment because of his or her HIV or AIDS status, or because he or she is regarded as having HIV or AIDS.

For more information about housing discrimination in Connecticut, see: Discrimination | Housing | Connecticut

Are there exceptions to the housing anti-discrimination laws?

Yes, Connecticut law exempts a rental portion of a single-family dwelling if the owner maintains and occupies part of the living quarters as his or her residence, or for the rental of a unit in a residence that has four or fewer apartments when the owner occupies one apartment. In addition, the Fair Housing act exempts, in some circumstances, ownership-occupied buildings with no more than four units, single-family housing sold or rented without the use of a broker and housing operated by organizations and private clubs that limit the occupancy to members.

Do Connecticut laws protect against discrimination by health care providers, businesses, and other public places?

Yes, under Connecticut law (Conn. Gen. Stat. sec. 46a-64), and the ADA, it is unlawful to exclude a person with HIV from a public place (what the law refers to as a “public accommodation”) or to provide unequal or restricted services to a person with HIV in a public place. Under both statutes, the term “public accommodation” includes any establishment or business that offers services to the public.

Therefore, people with HIV are protected from discrimination in virtually every public place or business, including bars, restaurants, hotels, stores, schools, vocational or other educational programs, taxi cabs, buses, airplanes, and other modes of transportation, health clubs, hospitals, and medical and dental offices, as long as these facilities are generally open to the public.

For more information about public accommodations discrimination in Connecticut, see Discrimination | Public Accommodations | Connecticut

Quels types d’arguments les médecins qui discriminent les personnes vivant avec le VIH avancent-ils, et sont-ils légitimes ?

Les médecins tentent généralement de justifier la discrimination à l’encontre des personnes vivant avec le VIH avec l’un des deux arguments suivants :

• « Traiter les personnes atteintes du VIH est dangereux » (Certains médecins refusent de traiter les personnes atteintes du VIH en raison d'une peur irrationnelle de la transmission du VIH) ; et
• « Traiter les personnes atteintes du VIH nécessite une expertise particulière » (Certains médecins orientent leurs patients vers d’autres prestataires de soins médicaux en se basant sur la croyance erronée selon laquelle les médecins généralistes ne sont pas qualifiés pour fournir des soins aux patients atteints du VIH).

Both an outright refusal to provide medical treatment and unnecessary referrals on the basis of a person’s disability are unlawful under the ADA and Connecticut law.

Comment les tribunaux et les experts médicaux ont-ils répondu à ces arguments ?

Les tribunaux et les experts médicaux ont répondu à ces arguments de la manière suivante :

1. “Treating People with HIV is Dangerous”

Les médecins et les dentistes peuvent prétendre légitimer leur refus de traiter un patient séropositif, par crainte de contracter le virus par piqûre d'aiguille ou autre exposition au sang. Cependant, des études menées auprès de professionnels de santé ont conclu que le risque de contracter le VIH par exposition professionnelle est minime, notamment grâce à l'application des précautions universelles.

C'est pour cette raison qu'en 1998, la Cour suprême des États-Unis a statué dans l'affaire Bragdon c. Abbott que les prestataires de soins de santé ne peuvent pas refuser de traiter les personnes atteintes du VIH en raison de préoccupations ou de craintes concernant la transmission du VIH (524 US 624 (1998)).

Outre l’aspect juridique, l’American Medical Association et l’American Dental Association, ainsi que de nombreuses autres organisations professionnelles de soins de santé, ont émis des politiques stipulant qu’il est contraire à l’éthique de refuser un traitement à une personne atteinte du VIH.

2. “Treating People with HIV Requires Special Expertise”

Dans ces cas, le bien-fondé d’une plainte pour discrimination dépend de la question de savoir si, sur la base de preuves médicales objectives, les services ou le traitement dont le patient a besoin nécessitent une orientation vers un spécialiste ou relèvent du champ de services et de la compétence du prestataire.

Dans États-Unis c. Morvant, un tribunal fédéral de première instance a rejeté la demande d'un dentiste selon laquelle les patients atteints du VIH nécessitent un spécialiste pour les soins dentaires de routine (898 F. Supp. 1157 (ED La 1995)). Le tribunal a souscrit au témoignage des experts qui ont déclaré qu'aucune formation ou expertise particulière, autre que celle d'un dentiste généraliste, n'est requise pour prodiguer des soins dentaires aux personnes atteintes du VIH. Le tribunal a spécifiquement rejeté les arguments du dentiste selon lesquels il n'était pas qualifié car il n'avait pas suivi la littérature et la formation nécessaires pour traiter les patients atteints du VIH. Bien que cette affaire ait été soulevée dans le contexte des soins dentaires, elle s'applique également à d'autres contextes médicaux.

Quelles sont les dispositions spécifiques de l’ADA qui interdisent la discrimination de la part des prestataires de soins de santé ?

En vertu du titre III de l'ADA (42 USC §§ 12181-12188), il est illégal pour un prestataire de soins de santé de :

1. Refuser à un patient séropositif la « jouissance pleine et égale » des services médicaux ou refuser à un patient séropositif la « possibilité de bénéficier » des services médicaux de la même manière que les autres patients.
2. Établir des « critères d’éligibilité » pour le privilège de recevoir des services médicaux, qui tendent à exclure les patients dont le test de dépistage du VIH est positif.
3. Fournir des services « différents ou séparés » aux patients séropositifs ou ne pas fournir de services aux patients dans le « cadre le plus intégré ».
4. Refuser l’égalité des services médicaux à une personne connue pour avoir une « relation » ou une « association » avec une personne vivant avec le VIH, comme un conjoint, un partenaire, un enfant ou un ami.

Quelles pratiques spécifiques en matière de soins de santé constituent une discrimination illégale à l’encontre des personnes vivant avec le VIH ?

En appliquant les dispositions spécifiques de l’ADA ci-dessus à la pratique des soins de santé, les pratiques suivantes sont illégales :

• Un professionnel de la santé ne peut pas refuser de traiter une personne atteinte du VIH en raison d’un risque perçu de transmission du VIH ou parce que le médecin ne se sent tout simplement pas à l’aise de traiter une personne atteinte du VIH.
• Un prestataire de soins de santé ne peut pas accepter de traiter un patient uniquement dans un cadre de traitement en dehors du cabinet habituel du médecin, comme une clinique hospitalière spécialisée, simplement parce que la personne est séropositive.
• Un professionnel de santé ne peut orienter un patient séropositif vers une autre clinique ou un autre spécialiste, sauf si le traitement requis sort du cadre de sa pratique habituelle ou de sa spécialité. L'ADA exige que l'orientation des patients séropositifs se fasse sur les mêmes bases que celle des autres patients. Il est toutefois permis d'orienter un patient vers des soins spécialisés si celui-ci présente des pathologies liées au VIH qui dépassent les compétences ou le champ d'intervention du professionnel de santé.
• Un professionnel de santé ne peut pas augmenter le coût des services prodigués à un patient séropositif afin de prendre des précautions supplémentaires allant au-delà des procédures de contrôle des infections prescrites par l'OSHA et les CDC. Dans certaines circonstances, le recours à des précautions supplémentaires inutiles, tendant à stigmatiser un patient simplement en raison de son statut VIH, peut même constituer une violation de l'ADA.
• Un prestataire de soins de santé ne peut pas limiter les heures prévues pour traiter les patients séropositifs, par exemple en insistant pour qu’un patient séropositif vienne en fin de journée.

What protections exist under Connecticut anti-discrimination law with regard to credit?

Any person who “regularly extends or arranges for the extension of credit” for which interest or finance charges are imposed (e.g. a bank, credit union, or other financial institution), may not discriminate because of HIV status in any credit transaction (Conn. Gen. Stat. sec. 46a-66).

For more information about credit and lending discrimination in Connecticut, see, Discrimination | Credit, Lending & Services | Connecticut.

Quels sont les recours potentiels en cas de discrimination en vertu de la loi fédérale ?

To pursue a claim under the Americans with Disabilities Act for employment discrimination, the employer must have at least 15 employees. A person must file a claim with the Equal Employment Opportunity Commission (EEOC) within 180 days of the date of the discriminatory act. A person may remove an ADA claim from the EEOC and file a lawsuit in state or federal court.

Pour intenter une action en justice en vertu de l'Americans with Disabilities Act pour discrimination dans un lieu public, une personne peut, sans passer par une agence administrative préalable, déposer une plainte auprès d'un tribunal d'État ou fédéral pour obtenir uniquement une injonction (c'est-à-dire une ordonnance du tribunal ordonnant la cessation du comportement discriminatoire). Les dommages et intérêts ne sont pas possibles en cas de violation du Titre III de l'ADA, sauf si le ministère de la Justice des États-Unis les demande. Cependant, une personne peut obtenir des dommages et intérêts en vertu de la Loi fédérale sur la réadaptation dans les affaires contre des entités bénéficiant de fonds fédéraux.

Pour faire valoir une réclamation en vertu de la Loi sur la réadaptation, une personne peut déposer une plainte administrative auprès du bureau régional du ministère fédéral de la Santé et des Services sociaux et/ou intenter une action en justice directement devant le tribunal.

Pour déposer une plainte en vertu de la loi nationale sur le logement équitable pour discrimination en matière de logement, une personne peut déposer une plainte auprès du Bureau du logement et du développement urbain des États-Unis dans un délai d'un an à compter de l'infraction. Une personne peut également intenter une action en justice dans un délai de deux ans à compter de l'infraction. Une action en justice peut être intentée, que la personne ait ou non déposé une plainte auprès du HUD.

Ressources

For more information about the CHRO complaint process see:

• How to File a Discrimination Complaint
• Complaint Processing

For information about filing a discrimination complaint under the ADA, see: 

• File a Complaint

HIV/AIDS | Testing & Privacy | Connecticut

Does Connecticut have a law governing HIV testing?

Yes, but the law was changed significantly in 2009 eliminating the need to get specific informed consent each time an HIV-related test is done and the need to do pre-test counseling. Instead, a general consent for medical care is sufficient as long as the general consent contains an instruction to the patient that the patient “may” be tested for HIV unless the patient “choose[s] not to be tested for HIV” (Conn. Gen. Stat. sec. 19a-582(a)). Under this system, the burden is on the patient who does not want to be tested for HIV to communicate that refusal to the healthcare provider.

If the person declines an HIV-related test, then that will be documented in the patient’s record, but otherwise the medical provider does not need to get the patient’s specific consent to perform an HIV-related test. The term “HIV-related test” includes a test for any agent “thought to cause or indicate the presence of HIV infection” (Conn. Gen. Stat. sec. 19a-581 (6)).

Are there requirements for what must be provided to the patient at the time the results of the HIV-related test are communicated?

Yes, Connecticut law specifies counseling or referral to counseling must be provided, as needed (Conn. Gen. Stat. sec. 19a-582 (c)):

• for coping with the emotional consequences of learning an HIV test result,
• regarding potential discrimination issues,
• for behavior modification to prevent transmission,
• to inform the person of available medical treatments and services and HIV support services agencies, and
• regarding the need to notify partners.

Un médecin peut-il tester un mineur pour le VIH sans le consentement d’un parent ou d’un tuteur ?

Yes, Connecticut law explicitly provides that the “consent of a parent or guardian shall not be a prerequisite to testing of a minor” (Conn. Gen. Stat. sec. 19a-582 (a)).

Connecticut law also requires that at the time a minor receives the test result, if he or she was tested without parental consent, the provider must give the minor counseling or referrals to “work towards” involving the minor’s parents in decision-making about medical care. In addition, the minor must receive actual counseling about the need to notify partners (Conn. Gen. Stat. sec. 19a-582 (c)).

Are there circumstances under which Connecticut law permits HIV testing, even against a person’s wishes?

Yes, Connecticut law permits involuntary HIV testing, without the need for informed consent, in several situations. The following four circumstances are the most important circumstances permitting involuntary testing:

1. Occupational Exposure – Significant Exposure Required

Connecticut law permits a nonconsensual “HIV-related test” of the source of a “significant exposure” (the threshold requirement that there be a “significant exposure” means “a parenteral exposure such as a needlestick or cut, or mucous membrane exposure such as a splash to the eye or mouth, to blood or a cutaneous exposure involving large amounts of blood or prolonged contact with blood, especially when the exposed skin is chapped, abraded, or afflicted with dermatitis.”  Conn. Gen. Stat. sec. 19a-581 (14).  Department of Health Services Regulations additionally list a variety of internal organ fluids whose contact can constitute a “significant exposure” and lists sexual assault in the course of occupational duties as a mode of “significant exposure” as well.  Voir Department of Public Health, Public Health Code sec. 19a-589-1(o) .Exposure to urine, feces, saliva, sweat, tears, and vomit is excluded, unless the fluid in question contains visible amounts of blood.  Likewise, human bites or scratches are excluded unless there is direct blood to blood or blood to mucous membrane contact. Id) to HIV which occurs during a person’s occupational duties (Conn. Gen. Stat. sec. 19a-582 (d)(5)).

In order to obtain a nonconsensual HIV test of a source, the subject employee must:

• Document the occurrence of a significant occupational exposure and complete an incident report within 48 hours;
• Have a negative baseline HIV test within 72 hours;
• Through a physician, have attempted to obtain and been refused, voluntary consent from the source;
• “Be able to take meaningful immediate action…which could not otherwise be taken” (such as beginning a prophylactic drug regimen or making decisions regarding pregnancy or breastfeeding); and
• Have an “exposure evaluation group” determine that the above criteria are met (an “exposure evaluation group” means at least three impartial health care providers, one of whom must be a physician, who determine the existence of a “significant exposure.”  Conn. Gen. Stat. sec. 19a-581 (15)).

How the Test Occurs

If the source is a patient in a health, correctional, or other facility, an available sample of blood may be tested or a blood sample may be drawn from the source and tested.

If the source is not in such a facility and a physician certifies that there has been a significant exposure, the worker may seek a court order for testing.

The employer must pay the cost of the HIV test.

2. Inability to Consent

A licensed health care provider may order a nonconsensual HIV test when the subject is unable to consent or lacks capacity to give or refuse consent and the test is necessary for “diagnostic purposes to provide appropriate urgent care” (Conn. Gen. Stat. sec. 19a-582 (d)(1)).

3. Prisoners

The Department of Correction may perform involuntary HIV testing on an inmate either because it is necessary for the diagnosis or treatment of an illness, or if the inmate’s behavior poses a significant risk of transmission to another inmate or has resulted in a significant exposure to another inmate (“Significant risk of transmission” means “sexual activity that involves transfer of one person’s semen, vaginal or cervical secretions to another person or sharing of needles during intravenous drug use.”  Conn. Gen. Stat. sec. 19a-581 (13)), (Conn. Gen. Stat. sec. 19a-582 (d)(6), (d)(7)). In both situations, there must be no reasonable alternative to testing available to achieve the same goal.

4. By Court Order

Connecticut law contains a broad provision permitting a court to order an HIV test when the court determines that there is a “clear and imminent danger to the public health or the health of a person and that the person has demonstrated a compelling need for the HIV-related test result which cannot be accommodated by other means” (Conn. Gen. Stat. sec. 19a-582 (d)(8)). In its assessment, the court must weigh the need for the test result against both the “privacy interests of the test subject and the public interest which may be disserved by involuntary testing” (Conn. Gen. Stat. sec. 19a-582 (d)(8)), (additional provisions for HIV testing without consent under Connecticut law include: (1) testing human organs, tissues, blood, or semen which are being used in medical research or therapy or for transplantation; (2) for research purposes if the identity of the subject cannot be determined; or (3) to determine the cause of death.  See Conn. Gen. Stat. sec. 19a-582 (d) generally).

Do the same laws that pertain to testing done by health organizations pertain to testing done by insurers?

No, Connecticut law makes a distinction between HIV testing by health organizations and HIV testing done by insurers. A separate set of laws governs HIV testing by insurers, rather than the general HIV testing statute (Conn. Gen. Stat. sec. 19a-586).

In order to take any HIV-related test of an insurance applicant, the insurer must obtain written informed consent (Conn. Gen. Stat. sec. 19a-586). The Commissioner of Insurance has developed a required format for such consent. An insurer may use an alternative form which must be filed with the Insurance Commissioner.

May life and health insurers and health centers disclose a positive HIV-related test result to any group for any reason?

Yes, the law permits life and health insurers and health centers to disclose a positive HIV-related test result to an organization that collects information about insurance applicants for the purpose of detecting fraud or misrepresentation, but such disclosure must be in the form of a code that includes many other test results and could not therefore be used to reasonably identify an applicant’s test result as an HIV-related test (Conn. Gen. Stat. sec. 19a-587).

Are there unique requirements for the administration of HIV tests for pregnant women and newborns?

Yes, any health care provider giving prenatal care to a pregnant woman must explain to her that HIV testing is a part of routine prenatal care and inform her of the health benefits to herself and her newborn of being tested for HIV infection. The requirements for consent and post-test counseling are the same as those discussed at the beginning of this topic (Conn. Gen. Stat. sec. 19a-593 (a)). If the woman consents to HIV testing the result will be listed in her medical file.

If a pregnant woman is admitted for delivery and there is no documentation of HIV-related testing in her medical record, the health care provider must inform her of the health benefits to herself and her newborn of being tested for HIV infection either before delivery or within 24 hours after delivery, and the health care provider must then administer an HIV test unless there is a specific written objection from the patient (Conn. Gen. Stat. sec. 19a-593 (b)).

Are there HIV testing laws that are specific to newborns?

Yes, all newborns shall be administered an HIV-related test as soon after birth as medically appropriate, unless the infant’s parents object to the test as being in conflict with their “religious practice.” This mandate does not apply if the mother was tested pursuant to the laws described above (Conn. Gen. Stat. sec. 19a-55 (a)).

In addition, the Department of Public Health may establish a registry of data on infants who have been exposed to HIV or AIDS medication in order to study the potential long-term effects of such medication on infants.

Is there an HIV-related law that governs HIV/AIDS vaccine researchers?

Yes, the HIV-related law that governs HIV/AIDS vaccine researchers states that when a drug is developed and tested to determine its success as a vaccine against HIV/AIDS, a manufacturer, research institution, or researcher will not be held liable for civil damages resulting from clinical trials where the drug is administered to research subjects. This immunity from liability must be presented to the research subject in writing and that person (or his or her parent or guardian in the case of a minor) must provide informed written consent to act as a research subject (Conn. Gen. Stat. sec. 19a-591(a & b)).

Are there laws in Connecticut that protect the privacy of medical information, such as HIV?

Connecticut law contains a broad prohibition against the disclosure by any person, without a written release, of “confidential HIV-related information” (the term “confidential HIV-related information” means any information “pertaining to” a person who has “been counseled regarding HIV infection, is the subject of an HIV-related test or, who has been diagnosed as having HIV infection, AIDS, or HIV-related illness.”  Conn. Gen. Stat. sec. 19a-581 (7), (8). It includes information which even reasonably could identify a person as having such conditions and information relating to such individual’s partners. Conn. Gen. Stat. sec. 19a-581 (8)), (Conn. Gen. Stat. sec. 19a-583 (a)).

Une personne vivant avec le VIH a-t-elle un droit constitutionnel à la vie privée ?

Many courts have found that a person has a constitutional privacy right to the nondisclosure of HIV status. Courts have based this right on the Due Process Clause of the U.S. Constitution, which creates a privacy interest in avoiding disclosure of certain types of personal information.

The constitutional right to privacy can only be asserted when the person disclosing the information is a state or government actor— e.g. police, prison officials, doctors at a state hospital.

Pour déterminer s’il y a eu violation de ce droit à la vie privée, les tribunaux mettent en balance la nature de l’intrusion dans la vie privée d’une personne et le poids à accorder aux raisons légitimes du gouvernement pour une politique ou une pratique qui entraîne la divulgation.

Are there circumstances under which Connecticut law permits the disclosure of HIV status without written informed consent?

Yes, Connecticut law provides for disclosure of HIV status under specifically prescribed circumstances:

• To a healthcare provider or facility when necessary to provide “appropriate care or treatment” (Conn. Gen. Stat. sec. 19a-583(a) (4)).
• To a healthcare worker or other employee where there has been a “significant occupational exposure” and the requirements articulated above are met.
• To employees of hospitals for mental illness operated by the Department of Mental Health and Addiction Services if the infection control committee determines the patient’s behavior poses a significant risk of transmission to another patient (Conn. Gen. Stat. sec. 19a-583 (a)(8)). Disclosure may only occur if it is likely to prevent or reduce the risk of transmission and no reasonable alternative, such as counseling, is available to achieve the same goal.
• To employees of facilities operated by the Department of Correction to provide services related to HIV-infection or if the medical director and chief administrator determine that the inmate’s behavior poses a significant risk of transmission to another inmate or has resulted in a significant exposure to another inmate at the facility (Conn. Gen. Stat. sec. 19a-583 (a)(9)).
• To life and health insurers in connection with underwriting and claims activity for life, health, and disability benefits (Conn. Gen. Stat. sec. 19a-583 (a)(11)).

To any person allowed access to such information by a court order, as described above. There are safeguards to protect the privacy of the source in any such court proceeding and subsequent disclosure of HIV-related information (Conn. Gen. Stat. sec. 19a-583).

How can violations of the testing and privacy statute be addressed?

Under Connecticut law, a person can recover compensatory damages for any injury suffered from a “willful” violation of the informed consent and confidentiality requirements (Conn. Gen. Stat. sec. 19a-590).

The phrase “willful” violation has been interpreted by the Supreme Court of Connecticut to mean simply that the disclosure of HIV-related information must be knowingly made. It need not be intended to produce injury (see Doe v. Marselle, 675 A.2d 835, 236 Conn. 845 (1996)).

Does Connecticut have reporting laws that require HIV or AIDS diagnoses to be reported to the Connecticut Department of Health?

Yes. All states require that certain health conditions be reported to public health authorities in order to track epidemiological trends and develop effective prevention strategies. Connecticut requires that physicians report to the Department of Public Health; 1) patients diagnosed with AIDS; 2) patients testing positive for HIV; 3) and children born to HIV positive women.  Information collected is kept confidential.

What does the phrase “duty to warn” refer to?

The term “duty to warn” refers to situations in which a counselor or physician may learn that a client is engaging in unsafe sex without having disclosed his or her HIV-positive status to the partner. Many people have asked whether there is a legal basis to breach client or patient confidentiality under these circumstances.

Does Connecticut have an HIV-specific duty to warn statute that pertains to physicians and public health officers?

Yes, Connecticut law permits both public health officers and physicians, under certain circumstances, to inform or warn partners that they may have been exposed to HIV (Conn. Gen. Stat. sec. 19a-584). The term “partner” means an “identified spouse or sex partner of the protected individual or a person identified as having shared hypodermic needles or syringes with the protected individual” (Conn. Gen. Stat. sec. 19a-581 (10)). The requirements for such a disclosure by a public health officer are that:

• There is a reasonable belief of a significant risk of transmission to the partner;
• The public health officer has counseled the individual regarding the need to notify a partner and reasonably believes that the individual will not disclose to the partner; and
• The public health officer has informed the protected individual of his or her intent to make the disclosure.

A physician may only warn or inform a known partner if both the partner and the individual with HIV are under the physician’s care. A physician may also disclose confidential HIV related information to a public health officer for the purpose of warning partners, if the physician takes the same steps with respect to his or her patient as public health officers must take above.

In making such a warning, the physician or public health official shall not disclose the identity of the HIV-infected individual and, where practicable, shall make such disclosure in person.

Does Connecticut have statutes that allow other health care providers to disclose a client’s HIV status?

No. The AIDS Law Project believes that any general laws related to “duty to warn” (Conn. Gen. Stat. sec. 52-146c, §52-146f) do not pertain to HIV disclosure, because Connecticut law specifically protects the confidentiality of HIV-related information and makes no exceptions for mental health providers, such as psychologists and social workers.

Connecticut law contains a broad prohibition on the disclosure of confidential HIV-related information by n'importe lequel person (Conn. Gen. Stat. sec. 19a-583). Since the Connecticut legislature specifically provided a narrow exemption permitting warning by physicians and public health officers only (Conn. Gen. Stat. sec. 19a-581(12)), there is a strong argument that the legislature has addressed that issue and decided not to permit other providers to disclose HIV status.

Nevertheless, the issue of duty to warn is an evolving and unclear area of law. 

Mental health professionals must consult an attorney or supervisor for advice if he or she believes that a client’s communications justify breaching client confidentiality and disclosing a client’s HIV status to a third person.

Are there requirements for how to disclose HIV-related information?

Yes, whenever confidential HIV-related information is disclosed, the disclosure must be accompanied by the following statement, or by a statement using substantially similar language:

“This information has been disclosed to you from records whose confidentiality is protected by state law.  State law prohibits you from making any further disclosure of it without the specific written consent of the person to whom it pertains, or as otherwise permitted by said law.  A general authorization for the release of medical or other information is NOT sufficient for this purpose.”

“An oral disclosure shall be accompanied or followed by such a notice within 10 days” (Conn. Gen. Stat. sec. 19a-585 (a)).

Notation of any disclosure must be made in the subject’s medical records, except for disclosures made:

• To federal or state authorities;
• In the course of ordinary medical review; or

To life and health insurers and government payers in connection with claims for life, health, and disability benefits.

Cases & Advocacy

To see HIV/AIDS cases or advocacy which GLAD has been directly involved with in Connecticut, go to: Cases and Advocacy – GLAD and under “By Issue” click on “HIV/AIDS” and under “By Location” click on “Connecticut.”

Actualités et communiqués de presse

To see news and press releases about HIV/AIDS in Connecticut, go to: News & Press Releases – GLAD and under “By Issue” click on “HIV/AIDS” and under “By Location” click on “Connecticut.”

HIV/AIDS | Other HIV-Related Issues | Connecticut

What does it mean that an employer may have to provide a “reasonable accommodation” for an employee with a disability?

Persons with disabilities, such as HIV/AIDS, may experience health-related problems that make it difficult to meet some job requirements or duties. For example, a person may be exhausted or fatigued and find it difficult to work a full-time schedule.

In certain circumstances, the employer has an obligation to modify or adjust job requirements or workplace policies in order to enable a person with a disability, such as HIV or AIDS, to perform the job duties. Under the ADA and the Connecticut Fair Employment Practices Act, this is known as a “reasonable accommodation.”

Examples of reasonable accommodations include:

• Modifying or changing job tasks or responsibilities;
• Establishing a part-time or modified work schedule;
• Permitting time off during regular work hours for medical appointments;
• Reassigning an employee to a vacant job; or
• Making modifications to the physical layout of a job site or acquiring devices such as a telephone amplifier to allow, for example, a person with a hearing impairment to do the job.

There is no fixed set of accommodations that an employee may request. The nature of a requested accommodation will depend on the particular needs of an individual employee’s circumstances.

How may a person obtain reasonable accommodation?

It is, with rare exception, the employee’s responsibility to initiate the request for an accommodation. In addition, an employer may request that an employee provide some information about the nature of the disability. Employees with concerns about disclosing HIV/AIDS status to a supervisor should contact GLAD Answers at (800) 455-GLAD (4523) in order to strategize about ways to address any such requests.

Does an employer have to grant a request for a reasonable accommodation?

No, an employer is not obligated to grant each and every request for an accommodation; an employer does not have to grant a reasonable accommodation that will create an “undue burden” (i.e., significant difficulty or expense for the employer’s operation). In addition, the employer does not have to provide reasonable accommodation if the employee cannot perform the job function even with the reasonable accommodation.

When is a “reasonable accommodation” for an employee an “undue burden” for an employer?

In determining whether a requested accommodation creates an undue burden or hardship for an employer, courts examine a number of factors, which include:

• The employer’s size, budget and financial constraints;
• The costs of implementing the requested accommodation; and
• How the accommodation affects or disrupts the employer’s business.

Again, each situation is examined on a case-by-case basis.

An employer only has an obligation to grant the reasonable accommodation if, as a result of the accommodation, the employee is then qualified to perform the essential job duties. An employer does not have to hire or retain an employee who cannot perform the essential functions of the job, even with a reasonable accommodation.

Do Connecticut laws provide for access to clean needles for injection drug users to prevent HIV transmission?

Under Connecticut law (Conn. Gen. Stat. sec. 21a-65) specific provision is made for needle and syringe exchange programs in the health departments of the three cities with the highest number of AIDS cases among intravenous drug users. These programs shall provide free and anonymous exchange of up to thirty needles and syringes per exchange and offer education about the transmission and prevention of HIV and offer assistance in obtaining drug treatment services.

Can I purchase a hypodermic needle or syringe over the counter at a pharmacy?

Yes. Connecticut law permits a pharmacy, health care facility, or needle exchange program to sell ten or fewer syringes to a person without a prescription (Conn. Gen. Stat. sec. 21a-65 (b)).

Ressources

For support and information about HIV/AIDS in Connecticut, see: https://aids-ct.org/

For information about Post-Exposure Prophylaxis (PEP) and Pre-Exposure Prophylaxis (PrEP), see:  CT Pre-exposure Prophylaxis (PrEP) Local Medical Services