105. Acquired Immunodeficiency Syndrome (AIDS)
105.994 Counseling and Testing of Pregnant Women for HIV
The Colorado Medical Society supports confidential HIV counseling and testing of all pregnant women at the earliest prenatal visit, except when there is a specific, signed refusal for testing, to ensure that pregnant women are educated regarding the risk of vertical transmission of HIV and the benefits of treatment and to allow HIV positive women the opportunity to improve their own health and that of their child.
(RES-65, AM 1996; Reaffirmed, BOD-1, AM 2014)
105.995 Needle Exchange Programs
The Colorado Medical Society supports the use of needle exchange programs in Colorado as part of a comprehensive harm reduction strategy for the express purpose of decreasing the transmission of blood-borne pathogens including Human Immunodeficiency Virus and Hepatitis.
(RES-7, IM 1996; Reaffirmed, BOD-1, AM 2014)
105.997 HIV Infection in Health Care Workers
The Colorado Medical Society (CMS) acknowledges that there is a theoretical risk of transmission of HIV infection from health care worker to patient; however, the risk is extremely low. The CMS supports the American Medical Association’s position on HIV infected physicians which states: “An HIV-infected physician should refrain from conducting exposure-prone procedures or perform such procedures with permission from the local review committee and the informed consent of the patient. A physician or other health care worker who performs exposure-prone procedures and becomes HIV-positive should disclose his/her serostatus to a state public health official or local review committee.” Such panel may be constituted within each hospital or as an independent program within the medical community. As is done by similar programs (e.g., Colorado Physician Health Program), the panel/program could accept referrals from persons other than the health care worker. The peer review panel/program should be charged with determining, periodically, the health care worker’s ability to continue to practice based on three criteria:(1) fitness for duty; (2) contagion; and (3) scientific evidence regarding risk of transmission from health care worker-to-patient.
The panel/program would re-evaluate the activities of the health care worker based on changes in the status of any of the three criteria. The CMS recommends that all persons who are at risk of acquiring HIV infection should determine their HIV status. Furthermore, the CMS supports the concept of voluntary, periodic testing for all health care workers if confidentiality can be guaranteed. The CMS does not support any mandatory testing of health care workers as a reasonable, reliable or effective approach. An HIV positive health care worker who does not pose an identifiable risk based on the application of the above criteria would not need to inform patients of their HIV seropositivity. However, the HIV positive health care worker who performs procedures with an identifiable risk of transmission as determined by the panel using the above criteria is obligated to inform his/her patients of his/her HIV status as part of the informed consent process. Patients always have the right to discuss their concerns about these issues with their health care providers and to ask their providers about their HIV status and risks of transmission. The CMS does not support mandatory public disclosure of anyone’s HIV status. The voluntary process described herein allows for a case-by-case determination of professional activities that pose an identifiable risk of transmission to the patient. It protects the patient. It also provides some protection to hospitals and health care workers and enables them to be proactive in advocating on behalf of both the provider and patient.
(RES-43, AM 1992; Reaffirmed, BOD-1, AM 2014)
105.999 Treatment of AIDS Patients
The Colorado Medical Society (CMS) is committed to the concept of treating AIDS patients and the AIDS-virus infected person in a compassionate and professional manner, which is consistent with the most current medical knowledge, and which protects both the public safety and individual civil liberties. The CMS encourages the treatment of AIDS patients, as in any other chronic but progressive disease, to be primarily in the outpatient setting until such time as the progression of the disease requires another treatment setting.
(RES-38, AM 1986; Reaffirmed, BOD-1, AM 2014)