Testing & Privacy | HIV/AIDS | Connecticut

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)).

Wi, lalwa Connecticut presize ke yo dwe bay konsèy oswa referans pou konsèy, jan sa nesesè (Conn. Gen. Stat. sec. 19a-582 (c)):

• pou fè fas ak konsekans emosyonèl lè w ap aprann rezilta yon tès VIH,
• konsènan pwoblèm diskriminasyon potansyèl yo,
• pou modifikasyon konpòtman pou anpeche transmisyon,
• pou enfòme moun nan sou tretman medikal ak sèvis ki disponib yo ansanm ak ajans sèvis sipò VIH yo, epi
• konsènan nesesite pou notifye patnè yo.

Wi, lalwa Connecticut la di klèman ke "konsantman yon paran oswa yon gadyen legal pa dwe yon kondisyon esansyèl pou fè tès sou yon minè" (Conn. Gen. Stat. sec. 19a-582 (a)).

Connecticut law also requires that at the time a minor receives the test result, if they were 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)).

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.  See 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)).

Pou jwenn yon tès VIH san konsantman sou yon sous, anplwaye ki konsène a dwe:

• Dokimante ensidan yon ekspozisyon okipasyonèl siyifikatif epi ranpli yon rapò ensidan nan 48 èdtan;
• Fè yon tès VIH debaz negatif nan lespas 72 èdtan;
• Atravè yon doktè, mwen te eseye jwenn epi yo te refize m konsantman volontè nan men sous la;
• "Pou kapab pran aksyon imedya ki enpòtan...ki pa t ap ka pran otreman" (tankou kòmanse yon rejim medikaman pwofilaksi oswa pran desizyon konsènan gwosès oswa bay tete); epi
• Fè yon "gwoup evalyasyon ekspozisyon" detèmine ke kritè ki anwo yo satisfè (yon "gwoup evalyasyon ekspozisyon" vle di omwen twa founisè swen sante san patipri, youn ladan yo dwe yon doktè, ki detèmine egzistans yon "ekspozisyon siyifikatif." Conn. Gen. Stat. sec. 19a-581 (15)).

Kijan Tès la Dewoule

Si sous la se yon pasyan nan yon etablisman sante, koreksyonèl oswa yon lòt etablisman, yo ka teste yon echantiyon san ki disponib oswa yo ka pran yon echantiyon san nan sous la epi teste li.

Si sous la pa nan yon etablisman konsa epi yon doktè sètifye ke te gen yon ekspozisyon siyifikatif, travayè a ka mande yon lòd tribinal pou fè tès la.

Patwon an dwe peye pri tès VIH la.

2. Inability to Consent

Yon founisè swen sante ki gen lisans ka bay lòd pou yon tès VIH san konsantman lè sijè a pa kapab bay konsantman oswa li pa gen kapasite pou bay oswa refize konsantman epi tès la nesesè pou "rezon dyagnostik pou bay swen ijans apwopriye" (Conn. Gen. Stat. sec. 19a-582 (d)(1)).

3. Incarcerated People

The Department of Correction may perform involuntary HIV testing on an incarcerated person either because it is necessary for the diagnosis or treatment of an illness, or if the incarcerated person’s behavior poses a significant risk of transmission to another incarcerated person or has resulted in a significant exposure to another incarcerated person (“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)). Nan toulede sitiyasyon yo, pa dwe gen okenn altènativ rezonab apa de tès la pou atenn menm objektif la.

4. By Court Order

Lalwa Connecticut gen yon dispozisyon laj ki pèmèt yon tribinal bay lòd pou yon tès VIH lè tribinal la detèmine ke gen yon "danje klè ak iminan pou sante piblik la oswa sante yon moun epi ke moun nan demontre yon bezwen ijan pou rezilta tès ki gen rapò ak VIH la ki pa ka akomode pa lòt mwayen" (Conn. Gen. Stat. sec. 19a-582 (d)(8)). Nan evalyasyon li a, tribinal la dwe peze bezwen pou rezilta tès la kont tou de "enterè vi prive sijè tès la ak enterè piblik la ki ka pa satisfè pa tès envolontè" (Conn. Gen. Stat. sec. 19a-582 (d)(8)), (lòt dispozisyon pou tès VIH san konsantman anba lalwa Connecticut gen ladan yo: (1) teste ògàn, tisi, san, oswa espèm imen ki itilize nan rechèch medikal oswa terapi oswa pou transplantasyon; (2) pou rezon rechèch si yo pa ka detèmine idantite sijè a; oswa (3) pou detèmine kòz lanmò a. Gade Conn. Gen. Stat. sec. 19a-582 (d) an jeneral).

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).

Pou kapab fè nenpòt tès VIH sou yon moun k ap aplike pou asirans, konpayi asirans lan dwe jwenn ekri konsantman enfòme (Conn. Gen. Stat. sec. 19a-586). Komisyonè Asirans lan devlope yon fòma obligatwa pou konsantman sa a. Yon konpayi asirans ka itilize yon lòt fòm ke li dwe depoze bay Komisyonè Asirans lan.

Wi, lalwa pèmèt konpayi asirans lavi ak sante ansanm ak sant sante yo divilge yon rezilta tès pozitif ki gen rapò ak VIH bay yon òganizasyon ki kolekte enfòmasyon sou aplikan asirans pou detekte fwod oswa fo reprezantasyon, men divilgasyon sa a dwe sou fòm yon kòd ki gen ladan anpil lòt rezilta tès e pakonsekan yo pa ka itilize pou idantifye rezilta tès yon aplikan kòm yon tès ki gen rapò ak VIH (Conn. Gen. Stat. sec. 19a-587).

Yes, any health care provider giving prenatal care to a pregnant person must explain to them that HIV testing is a part of routine prenatal care and inform the patient of the health benefits to themself and their 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 pregnant person consents to HIV testing, the result will be listed in their medical file.

If a pregnant person is admitted for delivery and there is no documentation of HIV-related testing in their medical record, the health care provider must inform them of the health benefits to themself and their newborn of being tested for HIV infection either before delivery or within 24 hours after delivery. 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)).

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 person who gave birth was tested pursuant to the laws described above (Conn. Gen. Stat. sec. 19a-55 (a)).

Anplis de sa, Depatman Sante Piblik la ka etabli yon rejis done sou tibebe ki te ekspoze a medikaman VIH oswa SIDA pou etidye efè potansyèl medikaman sa yo sou tibebe alontèm.

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 their 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)).

Lalwa Connecticut gen yon entèdiksyon laj kont divilgasyon pa nenpòt moun, 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)).

Anpil tribinal jwenn ke yon moun gen yon dwa konstitisyonèl pou l pa divilge estati VIH li. Tribinal yo baze dwa sa a sou Kloz Pwosesis Jis Konstitisyon Etazini an, ki kreye yon enterè nan vi prive pou evite divilgasyon sèten kalite enfòmasyon pèsonèl.

Yo ka sèlman fè vale dwa konstitisyonèl pou vi prive a lè moun ki divilge enfòmasyon an se yon aktè leta oswa gouvènman an — pa egzanp, lapolis, ofisyèl prizon, doktè nan yon lopital leta.

Pou detèmine si te gen yon vyolasyon dwa sa a pou vi prive, tribinal yo ap balanse nati entrizyon nan vi prive yon moun ak pwa yo dwe bay rezon lejitim gouvènman an pou yon politik oswa yon pratik ki lakòz divilgasyon.

Wi, lalwa Connecticut pèmèt divilgasyon estati VIH nan sikonstans espesifikman preskri:

• To a health care provider or facility when necessary to provide “appropriate care or treatment” (Conn. Gen. Stat. sec. 19a-583(a) (4)).
• To a health care worker or other employee where there has been a “significant occupational exposure” and the requirements articulated above are met.
• Pou anplwaye lopital pou maladi mantal ki opere pa Depatman Sante Mantal ak Sèvis Adiksyon si komite kontwòl enfeksyon an detèmine konpòtman pasyan an poze yon risk siyifikatif pou transmisyon bay yon lòt pasyan (Conn. Gen. Stat. sec. 19a-583 (a)(8)). Divilgasyon an ka fèt sèlman si li gen chans pou anpeche oswa diminye risk transmisyon an epi pa gen okenn altènatif rezonab, tankou konsèy, ki disponib pou reyalize menm objektif la.
• 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 incarcerated person’s behavior poses a significant risk of transmission to another incarcerated person or has resulted in a significant exposure to another incarcerated person at the facility (Conn. Gen. Stat. sec. 19a-583 (a)(9)).
• Pou konpayi asirans lavi ak sante an koneksyon avèk aktivite souskripsyon ak reklamasyon pou benefis lavi, sante ak andikap (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).

Dapre lalwa Connecticut, yon moun ka resevwa domaj konpansatwa pou nenpòt domaj li te sibi akoz yon vyolasyon "volontè" egzijans konsantman enfòme ak konfidansyalite (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 kont Marselle, 675 A.2d 835, 236 Koneksyon 845 (1996)).

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 people.  Information collected is kept confidential.

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

Wi, lalwa Connecticut pèmèt ni ofisye sante piblik yo ni doktè yo, nan sèten sikonstans, enfòme oswa avèti patnè yo ke yo ka te ekspoze a VIH (Conn. Gen. Stat. sec. 19a-584). Tèm "patnè" a vle di yon "konjwen idantifye oswa patnè seksyèl moun ki pwoteje a oswa yon moun ki idantifye kòm moun ki te pataje zegwi ipodèmik oswa sereng ak moun ki pwoteje a" (Conn. Gen. Stat. sec. 19a-581 (10)). Kondisyon pou yon ofisye sante piblik fè yon divilgasyon konsa se ke:

• Gen yon kwayans rezonab ke gen yon risk siyifikatif transmisyon bay patnè a;
• Ofisye sante piblik la te konseye moun nan konsènan nesesite pou l notifye yon patnè epi li kwè rezonabman ke moun nan pap di patnè a anyen; epi
• The public health officer has informed the protected individual of their 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 their patient as public health officers must take above.

Lè doktè a oswa ofisyèl sante piblik la ap bay yon avètisman konsa, li pa dwe devwale idantite moun ki enfekte ak VIH la, epi, lè sa posib, li dwe fè divilgasyon sa a an pèsòn.

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 any 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.

Sepandan, kesyon devwa pou avèti a se yon domèn lalwa ki ap evolye e ki pa klè.  Mental health professionals must consult an attorney or supervisor for advice if they believe that a client’s communications justify breaching client confidentiality and disclosing a client’s HIV status to a third person.

Wi, chak fwa yo divilge enfòmasyon konfidansyèl ki gen rapò ak VIH, divilgasyon an dwe akonpaye pa deklarasyon sa a, oubyen pa yon deklarasyon ki itilize yon langaj ki sanble anpil ak sa a:

"Yo divilge enfòmasyon sa a ba ou apati dosye ki pwoteje konfidansyalite pa lalwa leta a. Lalwa leta a entèdi ou fè nenpòt lòt divilgasyon san konsantman ekri espesifik moun ki konsène a, oswa jan lalwa sa a pèmèt. Yon otorizasyon jeneral pou divilgasyon enfòmasyon medikal oswa lòt enfòmasyon PA sifi pou objektif sa a."

"Yon divilgasyon oral dwe akonpaye oswa swiv pa yon avi konsa nan lespas 10 jou" (Conn. Gen. Stat. sec. 19a-585 (a)).

Nenpòt divilgasyon dwe make nan dosye medikal sijè a, eksepte pou divilgasyon ki fèt:

• Bay otorite federal oswa leta yo;
• Nan kou yon egzamen medikal òdinè; oubyen
• Pou konpayi asirans lavi ak sante ansanm ak kontribyab gouvènman an an koneksyon avèk reklamasyon pou benefis lavi, sante ak andikap.