Wednesday, August 27, 2014
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HIV patients deserve equal treatment

We live in a society that values openness and acceptance of difference, yet many people face unfair stigma and discrimination. No group experiences it more that those who live with HIV, and it is especially evident in the health care setting.

HIV patients deserve equal treatment

We live in a society that values openness and acceptance of difference, yet many people face unfair stigma and discrimination. No group experiences it more that those who live with HIV, and it is especially evident in the health care setting.

Federal laws protect those with HIV by explicitly prohibiting discrimination based on disability. It is illegal for hospitals, health clinics, dental offices, social services agencies, drug treatment centers, and nursing homes to provide them with lesser levels of service. However, disparate treatment still seems to occur with alarming frequency.

A 2005 study published in the Journal of General Internal Medicine found that 26% of HIV-infected individuals believed they had been the victim of discrimination by physicians and other health care providers. Of nearly 2,500 patients studied, most reported that a provider had been uncomfortable with them (20%), treated them as an inferior (17%), or preferred to avoid them (18%). These behaviors were attributed to providers at all levels, including physicians (54%), nurses and other clinical staff (39%), dentists (32%), hospital staff (31%) and case managers and social workers (8%).

This study was conducted eight years ago, but discrimination in the health care setting still seems to remain. Within the past two months, the Department of Justice has settled four cases involving HIV discrimination by medical providers. The most recent one – and most highly publicized –involved Glenbeigh Hospital of Rock Creek, Ohio, which refused to admit an HIV-positive patient to its alcohol treatment program.

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Other recent settlements involved a family dentistry office that required an HIV-positive patient to schedule all appointments in the last appointment slot of the day, a pain center physician who refused to treat an HIV-positive patient who was suffering from back pain resulting from a car accident, and an inpatient eating disorder treatment center that refused to treat an HIV-positive woman.

Last year, a patient sued Trinitas Medical Center in Elizabeth, New Jersey claiming that it refused him medication after his treating physician at the facility learned that he had contracted HIV from having sex with another man. According to the complaint, the physician said, “This is what he gets for going against God's will.”

While physicians are understandably concerned about the chance of contracting HIV from a patient, the risk of patient-to-physician infection has been shown to be extremely low. As long as the physician uses universal precautions, it is generally safe to treat patients with HIV or full-blown AIDS. The risk of infection from a needstick, the most likely route, is only 0.3%, even if the physician does not receive post-exposure treatment.

Of course, the emotional toll on providers of worrying about infection is significant, even though the risk is negligible. However, their concerns must be balanced against basic civil rights.

Medical treatment of HIV-positive patients should take place in a world of facts, not of myths. While health care worker safety should always be of the utmost importance, risks should be evaluated objectively. Individuals infected with HIV deserve the same rights as any other patients.

About this blog

The Field Clinic reports and analyzes health care laws, government policies, and political trends that are transforming the care we receive and the way we pay for it. Read more about our panel of bloggers here.

This blog is produced in partnership with Kaiser Health News, an editorially independent program of the Henry J. Kaiser Family Foundation, a nonprofit, nonpartisan health-policy research and communication organization not affiliated with Kaiser Permanente. Portions of this blog may also be found on Inquirer.com and in the Inquirer's Sunday Health Section.

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Robert I. Field, Ph.D., J.D., M.P.H. Professor, School of Law & Drexel School of Public Health
Jeffrey Brenner, MD Founder of the Camden Coalition of Healthcare Providers, Medical Director of the Urban Health Institute at Cooper University Healthcare
Andy Carter President & CEO, The Hospital & Healthsystem Assoc. of Pa.
Robert B. Doherty Senior Vice President of Governmental Affairs & Public Policy American College of Physicians
David Grande, MD, MPA Assistant Professor of Medicine at the University of Pennsylvania
Tine Hansen-Turton Chief Strategy Officer of Public Health Management Corporation
Drew A. Harris, DPM, MPH Director of Health Policy Program at the Jefferson School of Population Health
Antoinette Kraus Director of the Pennsylvania Health Access Network
Laval Miller-Wilson Executive Director of the Pennsylvania Health Law Project
David B. Nash, MD, MBA Founding Dean of the Jefferson School of Population Health
Mark V. Pauly, Ph.D. Professor of Health Care Management, Business Economics and Public Policy at The Wharton School
Howard J. Peterson, MHA Managing Partner of TRG Healthcare, a national healthcare consulting firm
Donald Schwarz, MD, MPH Deputy Mayor for Health & Opportunity and Health Commissioner for the City of Philadelphia
Paula L. Stillman, MD, MBA Healthcare consultant with special expertise in population health and disease management
Elizabeth A. W. Williams Senior Vice President & Chief Communications Officer for Independence Blue Cross
Krystyna Dereszowska A third-year law student concentrating in health at Drexel
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