HIV Discrimination

HIV Testing & Privacy (跳至章節)

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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.

Who is protected under these anti-discrimination laws?

• 患有愛滋病或愛滋病毒陽性的人，即使他們無症狀且沒有外在或明顯的疾病跡象。
• 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.

哪些法律保護愛滋病毒感染者免受就業歧視？

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 

這些反歧視法禁止什麼？

雇主不得僅因申請人或員工患有愛滋病毒或愛滋病等殘疾而對其採取不利行動。這意味著雇主不得基於申請人感染愛滋病毒或患有愛滋病的事實而解僱、拒絕僱用、重新僱用、晉升，或在僱用條款或條件中以其他方式進行歧視。

這裡的重點是愛滋病患者或愛滋病毒感染者是否與其他類似情況下的申請人或員工受到不同的待遇。

以下是非法歧視的例子：

• 雇主不得因擔心愛滋病毒感染者會傳染給其他員工或顧客而拒絕僱用該感染者。
• 雇主不得基於某人將來可能生病而無法勝任工作的可能性或機率而拒絕僱用或做出僱用決定。
• 雇主不能因為這會增加健康或工人賠償保險費而拒絕僱用某人。

What may an employer ask about an employee’s health during the application and interview process?

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:

• 您曾經住院或接受過醫師的照護嗎？
• 您是否曾經領取過工傷賠償或殘障福利？
• 你吃什麼藥？

After an offer of employment, can an employer require a medical exam? What guidelines apply?

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.

How have the courts addressed fears that health care employees who perform invasive procedures, such as surgeons, will transmit HIV to patients?

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.

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:

• The nature, duration and severity of the risk;
• 風險的機率；以及
• 是否可以透過合理的安排消除風險。

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 (4日 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.

評估雇主的歧視

雖然諮詢律師可能會有所幫助，但以下步驟可以幫助您開始考慮和評估潛在的就業歧視問題。

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 歧視性的 法律明確禁止的原因。
2. 為了證明歧視主張（即，您因歧視而不是某些正當理由而被解僱、降職等），您必須能夠證明以下內容：
   • 雇主知道或得知您是愛滋病毒陽性或患有愛滋病；
   • 無論是否有合理的便利條件，您都具備履行該工作基本職責的資格；並且
   • Adverse action was taken against you because of your HIV or AIDS status and the pretextual reason given by the employer for the adverse action is false.

3. 如果您的雇主知道您感染了愛滋病毒或愛滋病，請明確說明誰知道、他們是如何知道的以及他們何時發現的。如果您沒有告訴雇主，雇主還有其他途徑知道或懷疑您的愛滋病毒狀況嗎？
4. 考慮一下您認為自己因愛滋病毒感染狀況而受到區別對待的原因，包括以下方面：
   • 處於類似情況的其他員工是否受到了不同的待遇或相同的待遇？
   • 您的雇主是否遵守了其人事政策？
   • 雇主得知您的愛滋病毒狀況後不久就開始對您進行不利的待遇了嗎？
   • 您是否曾因病缺勤過一段時間，且返回工作崗位後是否開始受到不良治療？
   • 你的雇主對此事的描述是怎樣的？你該如何證明雇主的說法是錯的？

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:
   • 該公司如何運作？實際的住宿安排如何？
   • 站在主管的角度想想，對於你提出的合理安排，主管可能會提出哪些異議？例如，如果你需要在某個時間離開去看醫生，誰來接替你的工作？

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.

因此，愛滋病毒感染者在幾乎所有公共場所或企業都受到保護，免受歧視，包括酒吧、餐廳、酒店、商店、學校、職業或其他教育項目、計程車、公共汽車、飛機和其他交通工具、健身俱樂部、醫院以及醫療和牙科診所，只要這些設施通常向公眾開放。

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

What types of arguments do doctors who discriminate against people with HIV make, and are they legitimate?

醫生通常試圖用以下兩個論點之一來證明對愛滋病毒感染者的歧視是合理的：

• 「治療愛滋病毒感染者是危險的」（有些醫生因為對愛滋病毒傳播的非理性恐懼而拒絕治療愛滋病毒感染者）；
• 「治療愛滋病毒感染者需要特殊的專業知識」（有些醫生錯誤地認為全科醫生沒有資格為愛滋病毒感染者提供護理，因此將患者轉診給其他醫療服務提供者）。

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.

法院和醫學專家對這些論點有何反應？

Courts and medical experts have responded to these arguments in the following ways:

1. “治療愛滋病毒感染者是危險的”

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 needle sticks 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.

因此，1998年，美國最高法院就此案作出裁決 布拉格登訴阿博特案 that health care providers cannot refuse to treat people with HIV based on concerns or fears about HIV transmission (524 U.S. 624 (1998)).

In addition to the legal perspective, both the American Medical Association and the American Dental Association, and many other professional health care organizations, have issued policies that it is unethical to refuse treatment to a person with HIV.

2. “治療愛滋病毒感染者需要特殊的專業知識”

在這些情況下，歧視主張的是非曲直取決於基於客觀醫學證據，病人所需的服務或治療是否需要轉診給專科醫生，或是否屬於服務提供者的服務和能力範圍。

在 美國訴莫萬特案，一家聯邦審判法院駁回了一名牙醫的訴求，該牙醫聲稱愛滋病毒感染者需要專科醫生進行常規牙科護理（898 F. Supp. 1157 (ED La 1995)）。法院採納了專家的證詞，即除了一般牙醫所具備的技能外，無需任何其他特殊培訓或專業知識即可為愛滋病毒感染者提供牙科治療。法院特別駁回了該牙醫的論點，即他不具備資格，因為他沒有及時掌握治療愛滋病毒感染者所需的文獻和培訓。雖然此案發生在牙科護理的背景下，但它也適用於其他醫療環境。

What are the specific provisions of the ADA that prohibit discrimination by health care providers?

Under Title III of the ADA (42 U.S.C. §§ 12181-12188), it is illegal for a health care provider to:

1. Deny an HIV-positive patient the “full and equal enjoyment” of medical services or to deny an HIV-positive patient the “opportunity to benefit” from medical services in the same manner as other patients.
2. 建立接受醫療服務的“資格標準”，往往會篩選出愛滋病毒檢測呈陽性的患者。
3. 為愛滋病毒陽性患者提供「不同或單獨」的服務，或未能在「最全面的環境中」為患者提供服務。
4. 拒絕向已知與愛滋病毒感染者有「關係」或「交往」的人（如配偶、伴侶、子女或朋友）提供平等的醫療服務。

What specific health care practices constitute illegal discrimination against people with HIV?

將上述 ADA 的具體規定應用於醫療保健實踐，以下做法是違法的：

• A health care provider cannot decline to treat a person with HIV based on a perceived risk of HIV transmission or because the physician simply does not feel comfortable treating a person with HIV.
• A health care provider cannot agree to treat a patient only in a treatment setting outside the physician’s regular office, such as a special hospital clinic, simply because the person is HIV-positive.
• A health care provider cannot refer an HIV-positive patient to another clinic or specialist, unless the required treatment is outside the scope of the physician’s usual practice or specialty. The ADA requires that referrals of HIV-positive patients be made on the same basis as referrals of other patients. It is, however, permissible to refer a patient to specialized care if the patient has HIV-related medical conditions which are outside the realm of competence or scope of services of the provider.
• A health care provider cannot increase the cost of services to an HIV-positive patient in order to use additional precautions beyond the mandated OSHA and CDC infection control procedures. Under certain circumstances, it may even be an ADA violation to use unnecessary additional precautions which tend to stigmatize a patient simply on the basis of HIV status.
• A health care provider cannot limit the scheduled times for treating HIV-positive patients, such as insisting that an HIV-positive patient come in at the end of the day.

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.

根據聯邦法律，針對歧視有哪些潛在的補救措施？

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.

To pursue a claim under the Americans with Disabilities Act for discrimination in a place of public accommodation, a person may, without first going to an administrative agency, file a claim in state or federal court for injunctive relief only (i.e., seeking a court order that the discriminatory conduct cease). Money damages are not available for violation of Title III of the ADA unless they are sought by the United States Department of Justice. However, a person may recover money damages under the Federal Rehabilitation Act in cases against entities that receive federal funding.

為了根據《康復法》提出索賠，個人可以向聯邦衛生與公眾服務部地區辦事處提出行政投訴和/或直接向法院提起訴訟。

根據《國家公平住房法》，如需就住房歧視提起索賠，個人可在違規行為發生後一年內向美國住房和城市發展部 (HUD) 提出投訴。個人也可在違規行為發生後兩年內提起訴訟。無論個人是否已向 HUD 提出投訴，均可提起訴訟。

資源

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: 

• 提出投訴

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.

Can a physician test a minor for HIV without consent of a parent or guardian?

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.  看 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)).

愛滋病毒感染者是否享有憲法賦予的隱私權？

許多法院裁定，個人享有憲法賦予的隱私權，有權不揭露其愛滋病毒感染狀況。法院依據美國憲法中的正當程序條款裁定了這項權利，該條款賦予了避免披露某些類型的個人資訊的隱私利益。

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.

為了確定是否侵犯了隱私權，法院會權衡侵犯個人隱私的性質與政府制定披露政策或做法的合法理由。

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 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.

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.

案件與辯護

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

新聞與新聞稿

To see news and press releases about HIV/AIDS in Connecticut, go to: 新聞與新聞稿 – GLAD and under “By Issue” click on “HIV/AIDS” and under “By Location” click on “Connecticut.”

HIV/AIDS | Other HIV-Related Issues | Connecticut

雇主必須為身心障礙員工提供「合理便利」是什麼意思？

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.”

合理便利的例子包括：

• 修改或改變工作任務或職責；
• 制定兼職或修改的工作時間表；
• 允許在正常工作時間內請假去看醫生；
• 將員工重新分配到空缺職位；或
• 對工作現場的實體佈局進行修改或購買電話放大器等設備，以允許聽力障礙人士完成工作。

員工可以申請的便利條件沒有固定的設定。申請便利條件的性質將取決於每位員工的具體情況。

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.

雇主是否必須批准合理住宿請求？

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.

在什麼情況下，對員工而言「合理的便利」會成為對雇主而言「過度負擔」？

在確定所要求的便利性是否對雇主造成過度負擔或困難時，法院會審查許多因素，其中包括：

• The employer’s size, budget and financial constraints;
• 實施所要求的住宿的費用；以及
• 此調整如何影響或擾亂雇主的業務。

再次強調，我們會根據具體情況進行審查。

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)).

資源

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