PA 17-6—sSB 844

Public Health Committee

AN ACT CONCERNING THE DEPARTMENT OF PUBLIC HEALTH'S RECOMMENDATIONS REGARDING REVISIONS TO THE STATUTES CONCERNING THE HUMAN IMMUNODEFICIENCY VIRUS

SUMMARY: This act makes various changes to HIV-related laws, including:

1. changing the time frames for testing pregnant women for syphilis and HIV, by requiring the second test for each condition to occur at different intervals during the third trimester;

2. renaming the Department of Public Health's (DPH) needle and syringe exchange programs as “syringe services programs” to conform to existing practice, and making various changes to such programs;

3. narrowing the topics that must be addressed in counseling that providers ordering HIV tests must offer to patients as needed; and

4. removing a provision that specifically allowed patients to refuse to receive an HIV test result.

The act also makes minor, technical, and conforming changes.

EFFECTIVE DATE: July 1, 2017, except a conforming change is effective October 1, 2017.

1 — TESTING DURING PREGNANCY

The act updates provisions on HIV and syphilis testing of pregnant women. It specifies that the same requirements for ordering blood testing for these purposes apply to physicians, advanced practice registered nurses, physician assistants, and nurse midwives when any such providers are giving prenatal care. It eliminates obsolete language that distinguished between physicians and other prenatal care providers who were not authorized to take blood tests.

Under prior law and the act, the provider generally must test the patient for HIV and syphilis twice during the pregnancy. The act updates the required time frame for the second test. The time frames under prior law and the act are shown in Table 1.

Table 1: Schedule of HIV and Syphilis Testing During Pregnancy

Prior Law

The Act

First Test

Within 30 days after the first prenatal examination

Same as prior law

Second Test

During the 26th to 28th week of the pregnancy or shortly thereafter

(A test taken at delivery did not meet these requirements.)

Syphilis test: no later than the 28th to 32nd week of the pregnancy

HIV test: no later than the 32nd to 36th week

(If there is no documentation of the second test when the woman presents for labor and delivery, the second test must occur at the delivery.)

The act specifies that a woman may be subjected to these tests only once during each of the prescribed timeframes.

Under the act, the same requirements for consent for HIV testing apply as under existing law. Also, under existing law, unchanged by the act, (1) these provisions do not apply to women who object to a blood test on religious grounds and (2) the laboratory tests must be performed, on request, without charge by DPH.

The act also makes technical changes to these provisions.

2, 4 & 5 — SYRINGE SERVICES PROGRAMS

Existing law requires DPH, within available appropriations, to establish syringe exchange programs to improve the health of people who inject drugs in any community impacted by HIV or hepatitis C. DPH may authorize the programs through local health departments or other organizations.

The act refers to these programs as “syringe services programs,” rather than “needle and syringe exchange programs” as under prior law, and makes conforming changes. It also broadens the scope of the programs. The act:

1. requires the programs to provide access to syringe exchanges, as well as providing exchanges directly as under prior law;

2. eliminates the requirement that program participants receive an equal number of needles and syringes for those returned; and

3. specifically requires the programs to provide for safe disposal of syringes.

Existing law requires these programs to offer education on HIV, hepatitis C, and drug overdose prevention measures. The act specifies that the education must include ways to reduce harm caused by HIV and hepatitis C.

Existing law also requires these programs to monitor certain program data for evaluation purposes. The act requires this monitoring annually and specifies that its purpose is to determine if there is a reduction in the program's results.

3 — HIV TESTING AND RELATED COUNSELING

Under existing law, when communicating the results of an HIV test to a patient, the person who ordered the test generally must provide counseling or counseling referrals as needed, covering specified topics. The act eliminates the following from the list of required topics: (1) coping with the emotional consequences of learning the test result, (2) discrimination that could occur from disclosing the result, and (3) behavioral change to prevent transmitting or contracting HIV.

The act also eliminates provisions that:

1. specifically allowed patients to refuse to receive their test result and

2. required the person ordering the test to encourage patients to receive the result and to adopt behavioral changes to protect themselves and others from infection.