Management of HIV-Infected Providers

While HIV transmission from service providers to residents has proven to be extremely rare (CDC “Investigation”), the issue continues to create controversy. Indeed, no issue more dramatically illustrates the dilemma that healthcare organizations face in guarding the health of one group while protecting the rights of another.

This Risk Analysis discusses the issues surrounding HIV-infected healthcare providers in long-term care facilities, including current guidelines and proposed policy revisions, discriminatory concerns and liability issues, and considerations risk managers should take into account when developing a policy. While this issue is of more relevance in hospitals—where invasive procedures are commonly performed—risk managers at long-term care facilities should be aware of the issue and take steps to implement a policy as appropriate. Mechanisms for preventing occupational exposure and guidelines and regulatory requirements for postexposure testing and management are discussed elsewhere in the Continuing Care Risk Management(CCRM) System.

This Risk Analysis discusses the following topics regarding HIV-infected healthcare providers:

In 1990, the Centers for Disease Control and Prevention (CDC) reported that a Florida dentist with AIDS had transmitted HIV to 5 of approximately 1,100 (0.5%) patients who were evaluated (CDC “Update”). A sixth patient was diagnosed as HIV-positive in late 1992. The mode of transmission was never determined. The incident created heightened public concern about the risk of HIV transmission from healthcare providers to patients. CDC released its guidelines for managing HIV-infected healthcare providers in 1991. The CDC guidelines recommended, among other things, that HIV-infected providers who perform exposure-prone invasive procedures notify patients of their status prior to surgery. See Resource List for information...