Handbook of Operating Procedures 3-1310
Acquired Immune Deficiency Syndrome and Human Immunodeficiency Virus Infection
The University of Texas at Austin
Executive Sponsor: VP for University Operations
December 12, 1989
The University of Texas at Austin recognizes Human Immunodeficiency virus (HIV) as a serious public health threat and is committed to encouraging an informed and educated response to questions raised by faculty, staff, and students. Guidelines in this policy have been developed to address the medical, educational, legal, administrative, and ethical issues involved.
HIV causes a breakdown of the body's immune system, resulting in increased susceptibility to a variety of infections. In the early stages, a person infected with HIV may appear healthy, but may transmit the virus to others. Sometimes the individual's immune system deteriorates and the unusual infections characteristic of Acquired Immune Deficiency Syndrome (AIDS) develop.
To date, three groups of people are considered to be at risk for contracting HIV infection:
- Sexual Contact - Those having unprotected sexual contact with an infected individual.
- Blood Transfer - Those exposed to contaminated blood, blood components or products through needle sharing, injection, needle stick, or transfusions; and
- Perinatal - Infants infected by their mothers before, during, or after the time of birth.
Since its recognition as a distinct disease-causing virus in 1984, HIV has been intensively studied. The mode of transmission of HIV has been firmly established. Live HIV, in a dose sufficient to cause infection, must gain entry to the blood stream or mucous membranes to cause infection. Studies of family members of persons with AIDS/HIV show no evidence of transmission of the virus even after long-term casual exposure. Thus, in the normal workplace, academic and health care settings there is no risk of infection through casual contact. There are no known documented cases of the spread of HIV through tears; insect bites; handshaking; hugging; sleeping in the same bed; being coughed or sneezed on; touching inanimate objects; participating in sports competitions; or sharing restrooms, food or drink, gyms, swimming pools, living quarters or common eating areas. The probable explanation for this is that HIV can survive only inside living human cells. The virus is extremely fragile and dies very quickly outside of the body.
- Purpose of Guidelines
- The purpose of this policy is to provide guidelines for The University for compliance with The Human Immunodeficiency Virus Services Act, Senate Bill No. 959, 71st Legislature, Regular Session, and for responding to specific situations involving persons with AIDS or HIV infections in the following areas:
- Administrative policies;
- Residence life;
- Health education;
- Testing for HIV infection;
- Confidentiality of information related to persons with AIDS or HIV infection; and
- Patient Care.
- This policy is applicable to students and employees of The University.
- Throughout this document, "HIV infection" denotes the total spectrum of the disease, from HIV seropositive but asymptomatic infection to fully developed AIDS.
- General Policies
- Institutional Committee - The University will appoint a task force or institution-wide committee to oversee educational programs related to AIDS and HIV and to advise the administration on the implementation of these policies. The task force will include, as a minimum, representation from the faculty, the student body, and administrative areas such as housing services, health services, counseling services, and food services.
- Admissions - The existence of HIV infection will not be considered in admissions decisions unless current scientific information indicates required academic activities may expose others to risk of transmission.
- Employment - The existence of HIV infection will not be used to determine suitability of applicants for employment by The University. An HIV- infected employee will remain employed as long as he or she meets job performance standards and does not engage in job-related activities which current scientific information indicates may expose others to risk of transmission.
- Class Attendance - A student with HIV infection will be allowed to attend all classes without restrictions, as long as the student is physically and mentally able to participate, perform assigned work, and poses no health risk to others.
- Access To Facilities - A person with HIV infection will not be denied access to any University facility on the basis of HIV-positive status.
- Residential Housing - The University residential housing staff will not exclude HIV-positive students from University housing, and will not inform other students that a person with HIV infection lives in University housing.
- Testing for HIV Infection
- Mandatory Testing - No program for mandatory HIV testing of employees, students, or patients will be undertaken without that person's consent unless required by law or court order or as specified by Section III, G, 7.
- Voluntary Testing and Counseling - The University student health center will offer or refer students, faculty, and staff members for confidential or anonymous HIV counseling and testing services. All testing conducted by The University will include counseling before and after the test. Unless required by law, test results will be revealed to the person tested only when the opportunity is provided for immediate, individual, face-to-face counseling about:
- the meaning of the test result;
- the possible need for additional testing;
- measures to prevent the transmission of HIV;
- the availability of appropriate health care services, including mental health care, and appropriate social and support services in the geographic area of the person's residence;
- the benefits of partner notification; and
- the availability of partner notification programs.
- Informed Consent
- Unless otherwise authorized or required by law, no HIV test will be performed without informed consent of the person to be tested.
- Consent will be written on a separate form, or the medical record will document that the test has been explained and consent has been obtained. The consent form will state that post-test counseling will be offered or the medical record will note that the patient has been informed that post-test counseling will be offered.
- Reporting of Test Results - HIV test results will be reported in compliance with all applicable statutory requirements, including the Communicable Disease Prevention and Control Act, Texas Health and Safety Code, Sec. 81.001.
- Conditions of HIV Testing of Employees at University's Expense - Employees will be informed that they may request HIV testing and counseling at The University's expense, if:
- The employee documents possible exposure to HIV while performing duties of employment; and
- The employee was exposed to HIV in a manner that is capable of transmitting HIV as determined by guidelines developed in accordance with statements of the Texas Department of Health (TDH) and Center for Disease Control (CDC).
- Qualifying for Workers' Compensation Benefits - State law requires that an employee must provide a written statement of the date and circumstances of the exposure to HIV infection and document that within ten (10) days after the exposure, the employee had a test result that indicated absence of HIV infection. An employee who may have been exposed to HIV while performing duties of employment may not be required to be tested, but refusal to be tested may jeopardize workers' compensation benefits.
- Testing Following Potential Exposure to HIV - The University will develop guidelines and protocols for employees and students who have been exposed to material that has a potential for transmitting HIV as a result of employment or educational assignments. Testing of employees or students exposed to such material will be done within seven (7) days after exposure and will be repeated after one (1), three (3), and six (6) months. These guidelines follow TDH, U.S. Public Health Service, and CDC guidelines.
In cases of exposure of an employee or student to another individual's ("Individual" in this paragraph) blood or body fluid, The University, at University expense, may test that Individual for HIV infection with or without the Individual's consent, provided that the test is performed under approved institutional guidelines and procedures that provide criteria for testing and that respect the rights of the person being tested. This includes post-test counseling as specified in Section III, G, 2. If the test is done without the Individual's consent, the guidelines must ensure that any identifying information concerning the Individual's test will be destroyed as soon as the testing is complete and the person who may have been exposed is notified of the result. Test results will be reported in compliance with all applicable statutory requirements, as specified in Section III, G, 4.
- Confidentiality of Records - Except where release is required or authorized by law, information concerning the HIV status of students, employees or patients and any portion of a medical record will be kept confidential and will not be released without written consent. HIV status in personnel files and workers' compensation files is to remain confidential and have the confidentiality status of medical records.
- Safety Precautions - The University will develop guidelines for health care workers and students in the health professions concerning prevention of transmission of HIV and concerning health care workers who have HIV infection. Each University health care worker who is involved in hands-on patient care should complete an educational course about HIV infection based on the model education program and workplace guidelines developed by the TDH and the guidelines of this policy.
- Employee Educational Pamphlet - The University will provide each employee an educational pamphlet about methods of transmission and prevention of HIV infection. The pamphlet will be the TDH educational pamphlet or a pamphlet based on the model developed by the TDH. The pamphlet will be provided to new employees on the first day of employment and to all employees annually.
- Information on Prevention Provided to Student:
- The University will routinely offer students education based on the model HIV education and prevention program developed by the TDH and tailored to the students' cultural, educational, language, and developmental needs.
- The University student health center will provide information on prevention of HIV infection including:
- the value of abstinence and long-term mutual monogamy,
- information on the efficacy and use of condoms, and
- state laws relating to the transmission and to conduct that may result in the transmission of HIV.
- The employee educational pamphlet will be available to students on request.
- Guidelines for Laboratory Courses - Departments offering laboratory courses requiring exposure to materials that have potential for transmitting HIV will adopt safety guidelines for handling such material and distribute these guidelines to students and staff prior to such exposure.
- Distribution of Policy - The University will make this policy on HIV infection available to students, faculty and staff members by including the policy in the student, faculty and personnel guides if practicable, or by any other method. Institutional course catalogs should state that the educational pamphlet described in Subsection J, (a) is available to students.
- Education of Students Entering Health Professions - Each college or school offering medical, dental, nursing, allied health, counseling, and/or social work degree programs should include within the program curricula information about:
- methods of transmission and methods of prevention of HIV infection.
- federal and state laws, rules and regulations concerning HIV infection and AIDS, and
- the physical, emotional, and psychological stress associated with the care of patients with terminal illnesses.
- Unemployment Compensation Benefits - The University will inform employees via employee or faculty guides that state law provides that an individual will be disqualified for Unemployment Compensation benefits:
- If the Texas Employment Commission (TEC) finds that the employee left work voluntarily rather than provide services included within the course and scope of employment to an individual infected with a communicable disease, including HIV. This disqualification applies if The University provided facilities, equipment, training, and supplies necessary to take reasonable precautions against infection.
- If the TEC finds that the employee has been discharged from employment based on a refusal to provide services included within the course and scope of employment to an individual infected with a communicable disease, including HIV. This disqualification applies if The University provided facilities, equipment, training and supplies necessary to take reasonable precautions against infection.
- Health Benefits - No University student or employee will be subjected to impermissible discrimination under a health benefit plan endorsed by The University on the basis of a positive HIV test result.
Previously HOP 7.26