Discrimination | HIV/AIDS | New Hampshire

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

• Moun ki gen SIDA oubyen ki VIH pozitif, menm si yo pa gen okenn sentòm epi yo pa gen okenn siy maladi oubyen siy aparan.
• Moun yo konsidere oswa pèsevwa kòm moun ki gen VIH.
• Dapre lalwa federal, men pa dapre lalwa New Hampshire, yon moun ki pa gen VIH, men ki "asosye" ak yon moun ki gen VIH — tankou zanmi, mennaj, mari oswa madanm, moun k ap viv nan menm chanm avè l, asosye biznis, defansè ak moun k ap pran swen moun ki gen VIH.

People with HIV are protected under the New Hampshire Law Against Discrimination (RSA § 354-A), and the federal Americans with Disabilities Act (ADA).  Both of these statutes prohibit discrimination in employment on the basis of a person’s disability.  New Hampshire law covers workplaces with six or more employees.  The ADA covers workplaces with 15 or more employees.

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, or promote, or otherwise discriminate in the terms or conditions of employment, based on the fact that a person is HIV-positive or has AIDS.

Fòk nou konsantre isit la se si yon moun ki gen SIDA oswa VIH te trete yon fason diferan pase lòt kandida oswa anplwaye ki nan menm sitiyasyon.

Men kèk egzanp diskriminasyon ilegal:

• Yon patwon pa ka refize anboche yon moun ki gen VIH paske li pè ke VIH la ka transmèt bay lòt anplwaye oswa bay kliyan.
• Yon patwon pa ka refize anboche oswa pran yon desizyon sou anplwa ki baze sou posibilite, oswa menm pwobabilite, pou yon moun vin malad epi li pa pral kapab fè travay la nan lavni.

Yon anplwayè pa ka refize anboche yon moun paske sa ap ogmante prim asirans sante oswa konpansasyon travayè.

Under the ADA and New Hampshire law, 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:

• Èske ou janm te entène lopital oubyen anba swen yon doktè?
• Èske ou janm te resevwa benefis pou aksidan travay oswa andikap?
• Ki medikaman ou pran?

If an employer has 15 or more employees, they must comply with the ADA.  After a conditional offer of employment, the ADA permits an employer to 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, these 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 require a physical examination, only if it is job-related and consistent with business necessity.

If an employer has at least six but fewer than 15 employees, only New Hampshire law applies.  New Hampshire law allows employers, after making an offer of employment, to inquire into and keep records of existing or pre-existing physical or mental conditions (RSA § 354-A:7, III). New Hampshire law, however, does not mandate the specific requirements and limitations that are contained in the ADA regarding a post-offer exam.

The risk of HIV transmission from a health care worker to a patient is considered so small that it approaches zero.  Nevertheless, in cases where hospitals have sought to restrict or terminate the privileges of HIV-positive health care workers who perform invasive procedures, courts have reacted with tremendous fear and have insisted on an impossible “zero risk” standard.  As a result, the small number of courts that have addressed this issue under the ADA have upheld such terminations.

Dispozisyon anplwa ki nan ADA a prevwa ke yon anplwaye pa kalifye pou fè travay la si li poze yon "menas dirèk pou sante oswa sekirite lòt moun". Pou detèmine si yon anplwaye poze yon "menas dirèk", yon tribinal analize:

• Nati, dire ak gravite risk la;
• Pwobabilite risk la; epi
• Si wi ou non risk la ka elimine pa akomodasyon rezonab.

Sepandan, nan ka travayè swen sante ki VIH pozitif yo, tribinal yo inyore pwobabilite trè lejè risk la epi yo konsantre sou nati, dire ak gravite risk la. Ekstrè sa a ki soti nan yon ka resan se tipik apwòch tribinal yo:

“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 (4^yèm Anviwon 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.

Malgre ke li ka itil pou konsilte ak yon avoka, etap sa yo ka itil pou kòmanse konsidere ak evalye yon pwoblèm diskriminasyon nan travay potansyèl.

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, a 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. Pou w ka pwouve yon plent pou diskriminasyon (sa vle di, ke yo te revoke w, degrade w, elatriye akoz diskriminasyon epi non pa akoz yon rezon lejitim), ou dwe kapab montre bagay sa yo:

• Patwon-an te konnen oswa te dekouvri ke ou VIH pozitif oswa ou gen SIDA;
• Ou te kalifye pou fè fonksyon esansyèl travay la avèk oswa san aranjman rezonab; epi
• Yo te pran aksyon negatif kont ou akòz estati VIH oswa SIDA ou epi rezon pretèks anplwayè a bay pou aksyon negatif la se fo.

3. Si patwon ou konnen ou gen VIH oswa SIDA, idantifye egzakteman ki moun ki konnen, kijan yo konnen, ak ki lè yo te dekouvri sa. Si ou pa di patwon ou, èske gen nenpòt lòt fason patwon an ta ka konnen oswa sispèk estati VIH ou a?

4. Konsidere rezon ki fè ou kwè ke yo ap trete w yon fason diferan akòz estati VIH ou a, tankou domèn sa yo:

• Èske lòt anplwaye ki nan menm sitiyasyon yo te trete menm jan an oswa yon lòt jan?
• Èske patwon ou an te swiv règleman pèsonèl li yo?
• Èske tretman negatif la te kòmanse yon ti tan apre anplwayè a te aprann estati VIH ou a?
• Èske ou te pèdi travay ou akòz maladi pandan nenpòt peryòd tan epi èske tretman negatif la te kòmanse lè ou te retounen nan travay?
• Ki vèsyon patwon ou a pral bay sou evènman yo? Kijan ou pral pwouve ke vèsyon patwon an se fo?

5. Èske w gen difikilte pou w ranpli devwa travay ou akòz nenpòt pwoblèm sante oswa medikal ki gen rapò ak VIH? Èske kondisyon w lan anpeche w travay aplentan, oswa èske w bezwen pran konje pou randevou medikal, travay ki pi lejè oswa yon pozisyon ki mwens estrèsan? Ou ta ka vle eseye fè brainstorming pou kreye yon aranjman rezonab ke ou ka pwopoze bay anplwayè w la. Men kèk pwen pou w konsidere:

• Ki jan konpayi an fonksyone e kijan akomodasyon an ta mache an pratik?
• Mete tèt ou nan plas sipèvizè w la. Ki objeksyon yo ta ka soulve kont aranjman rezonab yo mande a? Pa egzanp, si ou bezwen kite nan yon sèten lè pou randevou medikal, ki moun ki ta ranplase devwa w yo?

It is illegal, under both New Hampshire law (RSA § 354-A:12) 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.

In addition, a person cannot be discriminated against because of his or her “association” with a person with HIV.  This means a person cannot be discriminated against because his or her roommate, lover, relative, or business partner has HIV.

Wi, gen eksepsyon nan lalwa New Hampshire pou kay unifamilyal ke pwopriyetè a lwe; pou rezidans ki gen 3 apatman oswa mwens lè pwopriyetè a okipe yon sèl apatman; epi pou rezidans ki gen senk chanm oswa mwens lè pwopriyetè a oswa fanmi pwopriyetè a ap viv nan yon sèl chanm (RSA § 354-A:13). Anplis de sa, Lwa sou Jistis nan Lojman an egzante, nan sèten sikonstans, bilding ki okipe pa pwopriyetè yo ki pa gen plis pase kat inite, lojman unifamilyal ki vann oswa lwe san yo pa itilize yon koutye ak lojman ki opere pa òganizasyon ak klib prive ki limite okipasyon an pou manm yo sèlman.

Yes, under New Hampshire law (RSA § 354-A:1) 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.  In addition, the Federal Rehabilitation Act of 1973 (29 U.S.C.A. § 794) prohibits discrimination on the basis of disability in any agency or program that receives federal funding, including hospitals, medical or dental offices, and educational institutions.

Se poutèt sa, moun ki gen VIH yo pwoteje kont diskriminasyon nan prèske tout kote piblik oswa biznis, tankou ba, restoran, otèl, magazen, lekòl, pwogram pwofesyonèl oswa lòt pwogram edikasyonèl, taksi, otobis, avyon ak lòt mwayen transpò, klib sante, lopital ak kabinè medikal ak dantis, depi etablisman sa yo jeneralman ouvè pou piblik la.

Kwè li ou pa, wi, moun ki gen VIH toujou ap fè fas ak diskriminasyon nan men lopital, doktè, dantis ak lòt founisè swen sante. Diskriminasyon sa a ka pran fòm yon refi kareman pou bay sèvis medikal oswa yon referans ilegal akòz estati VIH yon pasyan.

Doktè yo tipikman eseye jistifye diskriminasyon kont moun ki gen VIH ak youn nan de agiman sa yo:

1. “Trete Moun ki gen VIH se Danjere” (Gen kèk doktè ki refize trete moun ki gen VIH paske yo pè pou yo pa transmèt VIH); epi
2. "Tretman Moun ki gen VIH Mande Ekspètiz Espesyal" (Gen kèk doktè ki refere pasyan yo bay lòt founisè swen medikal ki baze sou yon kwayans ki pa kòrèk ke doktè jeneralis yo pa kalifye pou bay swen pasyan ki gen VIH).

Ni yon refi kareman pou bay tretman medikal ni referans nesesè akoz andikap yon moun se ilegal anba lalwa ADA ak New Hampshire.

Tribinal yo ak ekspè medikal yo te reponn a agiman sa yo nan fason sa yo:

1. “Treating People with HIV is Dangerous”

Doctors and dentists may claim that a refusal to treat a patient with HIV is legitimate because they fear they might contract HIV themselves through needlesticks or other exposures to blood.  However, studies of health care workers have concluded that risk of contracting HIV from occupational exposure is minuscule, especially with the use of universal precautions.

For this reason, in 1998, the United States Supreme Court ruled in the case Bragdon v. Abbott that health care providers cannot refuse to treat people with HIV based on concerns or fears about HIV transmission (524 U.S. 624 (1998)).

Anplis pèspektiv legal la, ni Asosyasyon Medikal Ameriken an ni Asosyasyon Dantè Ameriken an ansanm ak anpil lòt òganizasyon pwofesyonèl swen sante te pibliye règleman ki di li pa etik pou refize tretman bay yon moun ki gen VIH.

2. "Tretman Moun ki gen VIH mande yon ekspètiz espesyal"

Nan ka sa yo, merit yon plent pou diskriminasyon depann de si, ki baze sou prèv medikal objektif, sèvis oswa tretman pasyan an bezwen an mande yon rekòmandasyon bay yon espesyalis oswa si li nan kad sèvis ak konpetans founisè a.

In United States v. Morvant, a federal trial court rejected a dentist’s claim that patients with HIV require a specialist for routine dental care (898 F. Supp. 1157 (E.D. La 1995)). The court agreed with the testimony of experts who said that no special training or expertise, other than that possessed by a general dentist, is required to provide dental treatment to people with HIV. The court specifically rejected the dentist’s arguments that he was unqualified because he had not kept up with the literature and training necessary to treat patients with HIV. While this case arose in the context of dental care, it is applicable to other medical settings as well.

Anba Tit III ADA a (42 USC §§ 12181-12188), li ilegal pou yon founisè swen sante:

• Refize yon pasyan ki VIH pozitif pou "jwi sèvis medikal yo nèt ale epi egalman" oubyen refize yon pasyan ki VIH pozitif pou "benefisye" sèvis medikal yo menm jan ak lòt pasyan yo.
• Etabli "kritè kalifikasyon" pou privilèj pou resevwa sèvis medikal yo, ki gen tandans pou elimine pasyan ki teste pozitif pou VIH.
• Bay pasyan ki VIH pozitif oswa ki pa bay pasyan sèvis "diferan oswa separe" nan "anviwònman ki pi entegre a".
• Refize sèvis medikal egal a yon moun ke yo konnen ki gen yon "relasyon" oswa "asosyasyon" ak yon moun ki gen VIH, tankou yon mari oswa yon madanm, yon patnè, yon pitit, oswa yon zanmi.

Lè nou aplike dispozisyon espesifik ADA ki anwo yo nan pratik swen sante, pratik sa yo ilegal:

1. Yon founisè swen sante pa ka refere yon pasyan ki gen VIH bay yon lòt klinik oswa yon lòt espesyalis, sof si tretman ki nesesè a pa nan kad pratik abityèl oswa espesyalite doktè a. ADA a egzije pou referans pasyan ki gen VIH yo fèt sou menm baz ak referans lòt pasyan yo. Sepandan, li pèmèt pou refere yon pasyan bay swen espesyalize si pasyan an gen kondisyon medikal ki gen rapò ak VIH ki pa nan kad konpetans oswa sèvis founisè a.
2. Yon founisè swen sante pa ka refize trete yon moun ki gen VIH paske li santi li gen risk transmisyon VIH la oubyen paske doktè a tou senpleman pa santi l alèz pou trete yon moun ki gen VIH.
3. Yon founisè swen sante pa ka dakò pou trete yon pasyan sèlman nan yon anviwònman tretman deyò biwo abityèl doktè a, tankou yon klinik espesyal nan yon lopital, tou senpleman paske moun nan VIH pozitif.
4. Yon founisè swen sante pa ka ogmante pri sèvis pou yon pasyan ki gen VIH pou l ka itilize prekosyon adisyonèl anplis pwosedi kontwòl enfeksyon OSHA ak CDC yo egzije. Nan sèten sikonstans, li ka menm yon vyolasyon ADA pou itilize prekosyon adisyonèl ki pa nesesè ki gen tandans estigmatize yon pasyan tou senpleman sou baz estati VIH li.

Yon founisè swen sante pa ka limite lè yo pwograme pou trete pasyan ki gen VIH, tankou ensiste pou yon pasyan ki gen VIH vini nan fen jounen an.