AIDS & HIV Infection (Policy)April 24, 1998 (Replaces "Policy Concerning AIDS and AIDS-related Conditions" dated September 21, 1989)
The following are definitions or explanations of terminology used in this policy:
AIDS -- Acquired immunodeficiency syndrome occurs in someone with HIV infection when one or more of certain diseases or infections occurs or when a CD4 (also known as T4 helper) lymphocyte cell count is below 200.
HIV -- Human immunodeficiency virus (the virus which causes AIDS).
HIV antibody -- A protein in the body produced in response to infection with HIV. (There are tests which look for HIV antibody in a person infected with HIV.)
HIV infection -- A condition involving asymptomatic (without symptoms) or symptomatic (with symptoms) stages of infection.
Human immunodeficiency virus (HIV) is the virus which causes the disease, AIDS. Infection with that virus damages the human body's immune (defense) system and allows life-threatening infections to develop. HIV has no known cure or vaccine for prevention. Available medical knowledge indicates that transmission of HIV is primarily through sexual contact or sharing intravenous drug paraphernalia with someone who has an HIV infection. It also can be spread from an infected mother to her baby before, or during, delivery and through breast feeding. HIV cannot be transmitted through casual contact such as sharing food or drink, touching surfaces, shaking hands, dry kissing, or working together. HIV cannot be transmitted by mosquitoes or other insects.
Even if there are no symptoms, an HIV-infected person can transmit HIV to a sexual partner or to a needle-sharing partner.
Because of the seriousness of the HIV/AIDS issue, the University of Alabama at Birmingham has established this policy which focuses on prevention (through detailed education of students, faculty, and staff) and on the compassionate care of people with HIV infection or AIDS.
A supervisor or anyone in the UAB community who becomes aware of an HIV/AIDS-related situation involving an employee, student, or visitor shall follow the guidelines stated in this policy.
1. Admissions or Employment
The University of Alabama at Birmingham accepts otherwise-qualified individuals presenting themselves for admission or employment, irrespective of their HIV status.
2. Handicapping Conditions
Persons with AIDS (and, possibly, those with other manifestations of HIV infection) will be considered as having handicapping conditions as defined in the Rehabilitation Act of 1973 and the Americans with Disabilities Act. In determining policy and in making related decisions, UAB officials shall properly attend to the legal rights of these individuals and shall make reasonable accommodations as are appropriate for individuals with handicapping conditions.
Decisions regarding the continuation of employment of faculty and staff with HIV infection or AIDS will be made on the basis of job-related criteria. Within current UAB policies and procedures, individuals may be reassigned to accommodate a disabling condition. Termination will be pursued only when the employee, even with reasonable reassignment of responsibilities, can no longer perform the duties and responsibilities of his or her position. Any such termination action will be taken in accordance with established UAB procedures.
3. Student Attendance
UAB students who have HIV infections, whether they are symptomatic or asymptomatic, will be allowed regular classroom attendance as long as they are physically and mentally able to attend classes as determined by current UAB academic standards.
HIV-infected students enrolled in UAB health profession schools may have their educational program modified by their school to limit the risk of disease transmission, in accordance with the Alabama Infected Health-care Worker Management Act.
4. Access to Facilities
There will be no unreasonable restriction of access on the basis of HIV infection to student or employee facilities, theaters, restaurants, snack bars, gymnasiums, swimming pools, saunas, recreational facilities, or other common areas.
5. Student Housing
Currently available medical information does not indicate that there exists a risk of transmission of infection by casual contact which would preclude sharing a residence with a person with AIDS or HIV infection. However, there may be reasonable concern for the health of students with immune deficiencies (of any origin) when those students might be exposed to certain contagious diseases (for example, measles or chicken pox) in a close living situation. For these reasons, decisions regarding housing and private rooms for students with HIV infections will be made on a case-by-case basis by UAB Student Housing and Residential Life officials. It is the responsibility of the student to make his/her HIV status known to UAB in order for any accommodation request to be considered. It also is the responsibility of an HIV-infected student to take necessary precautions to avoid exposure of others to infection through known means of transmission.
In general, students, student applicants, employees, and applicants for employment at UAB will not be asked to respond to questions concerning the existence of HIV infection. However, both students and employees with HIV infection are encouraged to inform campus health-care providers so that UAB may provide information about proper medical care, medical care availability, support, counseling, and education. This, like any other medical information, will be handled in a strictly confidential manner in accordance with established UAB policy and Alabama law.
Incoming students known to have HIV infection need not be exempted from UAB requirements for nonlive virus vaccinations. However, because of potentially serious consequences for HIV-infected persons' receiving live virus vaccines, persons who are recommended to receive such immunizations should consult the UAB Student Health Center or the Jefferson County Department of Health for current recommendations.
8. Information, Testing, and Counseling
Students or employees requesting HIV antibody testing will be referred to the Jefferson County Department of Health. UAB University Hospital employees also may receive such testing through the Employee Health Services.
Counseling, information, and education are available through various UAB units including the Student Health Service, the Division of Student Affairs, the Hospital Employee Health Service, and the Office of Human Resource Management. These services currently are made available to the students or employees at no cost and in accordance with the guidelines in each unit.
9. Confidentiality of Information
No information concerning HIV infection or AIDS or their diagnoses will be provided to any third party other than an employee's immediate supervisor without the expressed written consent of the infected person. Medical information cannot be released to any person, group, agency, insurer, employer, or institution without specific written consent of the patient or legal guardian, except as required by law. All disclosures of diagnoses of HIV infection or AIDS to individuals functioning in supervisory roles must be treated as confidential information.
According to present law, UAB physicians and other health-care providers are mandated to protect the confidentiality of medical information with exceptions being made only if the need arises to protect others in very specific, life-threatening circumstances. Also, disclosure by persons other than health-care providers that an individual has HIV infection or AIDS may be considered an invasion of that individual's privacy. Situations in which disclosure will be made will be determined on a case-by-case basis in consultation with the chair of the AIDS Activities Coordinating Committee and the Office of Counsel, if needed.
B. Public Health Reporting Requirements
UAB will observe the public health reporting requirements of the Alabama State Department of Public Health. Individuals known to have HIV infection will be reported to the State Department of Public Health according to prevailing statutes.
C. "Need to Know"
According to the American College Health Association, current medical information concerning HIV neither justifies nor requires warning others of the presence of someone with HIV infection or AIDS. Given the absence of any evidence of transmission of HIV by casual contact, there is no need or justification for warning individuals in the academic workplace, administrative officers, or instructors of the presence of such an individual. Therefore, the number of people at UAB who will be aware of the existence and/or identity of students or employees who have HIV infection will be kept to an absolute minimum, both to protect the confidentiality and the privacy of the infected persons and to avoid the generation of unnecessary fear and anxiety among faculty, staff, and students.
Training requirements for employees deemed at-risk by the AIDS Activities Coordinating Committee shall consist of sessions sufficient in number and depth to comply with prevailing Centers for Disease Control and Prevention recommendations and "Bloodborne Pathogens Standards." In the absence of such guidelines, the AIDS Activities Coordinating Committee shall determine educational standards. Records of AIDS education training for at-risk employees shall be maintained in the appropriate UAB Human Resource Management office.
11. Safety Precautions
Since many people with HIV infection are not identified in advance, universal precautions as defined by the Centers for Disease Control and Prevention and by the Occupational Safety and Health Administration will guide the procedures for the handling of blood and body fluids containing viable blood of any student, employee, or patient. Questions regarding these safety guidelines should be directed to the Department of Occupational Health and Safety, the Hospital Employee Health Service, the Office of Human Resource Management, the Hospital Committee on Infections, or the UAB Biosafety Committee. Each unit has the responsibility for developing department-specific directives and procedures. Departments also have the responsibility for compliance monitoring and staff education to prevent the transmission of HIV infection.
Manuals and procedures already in use at UAB cover the precautions which should be taken when handling infectious materials. Certain of those procedures are re-emphasized here especially as pertains to the transmission of HIV infection.
UAB personnel will use disposable, single-use needles and other equipment whenever such equipment will puncture the skin or mucous membranes of patients, employees, or students. Extreme caution should be exercised when handling sharp objects, particularly in disposing of needles. All used needles should be placed in puncture-resistant containers designated for this purpose. Needles should never be bent or recapped after use. Any needles which are made to be re-used or other equipment that punctures skin or mucous membranes should be appropriately cleaned and sterilized before re-use. Blood-soaked articles should be placed in leak-proof bags with biohazard labels before being sent for reprocessing or disposal in accordance with established UAB infection control guidelines.
C. Teaching Laboratories
Laboratory courses requiring exposure to blood, such as biology courses in which blood is obtained by finger prick for typing or examination, should use disposable equipment, and no lancets or other blood-letting devices should be re-used or shared. No students, except those in health-care professions, should be required to obtain or process the blood of others.
12. Job Performance
Faculty, staff, students, and all other persons affiliated with UAB shall perform the responsibilities of their positions irrespective of the HIV status of patients, students, or co-workers. Failure to comply with this policy will be considered a failure to adequately perform the responsibilities of one's position and may result in disciplinary action up to, and including, discharge.
13. Behavior Risk
UAB students, faculty, and staff with HIV infection or AIDS who are aware of the potential danger of their condition to others and who engage in behavior (while performing their employee-related or student-related activities) which threatens the safety and welfare of others may be subject to disciplinary action in accordance with established UAB disciplinary procedures and/or applicable law.
Applicability to Other UAB AIDS Policies
More specific, written guidelines and procedures are the responsibility of individual departments and may be developed, as needed, by department/unit heads. All unit policies must be compatible with this UAB-wide policy and may not be in conflict with it.
NOTE: See also UAB University Hospital policies concerning prevention of transmission of HIV infections.