Connecticut Governor Dannel Malloy recently signed into law Public Act 17-6 (PA 17-6), a bill that makes certain revisions to state laws concerning human immunodeficiency virus (HIV) testing and syringe services programs pursuant to recommendations of the Department of Public Health (DPH). The substantive provisions of this legislation take effect July 1, 2017.
Currently, Conn. Gen. Stat. §19a-90 states that physicians furnishing prenatal care to pregnant women shall take (or cause to be taken) a blood sample within 30 days of the woman’s first examination, and again during the final trimester of her pregnancy (between the 26th and 28th week of gestation, or shortly thereafter), to be tested for syphilis and an HIV-related test (i.e., a test for indicators of HIV infection) by a DPH-approved laboratory.
This legislation expands Conn. Gen. Stat. §19a-90 to apply more broadly to “health care providers” providing prenatal care to pregnant women, which term is defined to include – in addition to licensed physicians – licensed advanced practice registered nurses, physician assistants, and nurse-midwives. This legislation also clarifies that a health care provider meets his/her obligation under the statute by “ordering” (not taking or causing to be taken) the required tests, and specifies the following timeframe for such testing:
- serological test for HIV infection and syphilis within 30 days following the woman’s first prenatal examination;
- a serological test for syphilis not later than 28-32 weeks of gestation; and
- a serological test for HIV infection not later than 32-36 weeks of gestation.
In the event a woman presents to labor and delivery without documentation of the follow-up serological tests for syphilis and HIV infection under (2) and (3) above, this legislation states that a health care provider must order a serological test for HIV infection and syphilis at the time of delivery. This legislation also provides that no woman may be subjected to more than one serological test for either syphilis or HIV infection during the timeframes contemplated above, and each woman subject to testing under this legislation must give consent in accordance with the state’s informed consent law for HIV-related testing (Conn. Gen. Stat. §19a-582). Additionally, in lieu of sending the tests to a DPH-approved laboratory, this legislation provides that DPH will conduct the mandatory tests at no charge.
Relatedly, PA 17-6 updates the information concerning counseling availability that is to be furnished to a person upon receipt of the results of an HIV-related test. As a result of this legislation, a person communicating the results of an HIV-related test is no longer required to provide counseling (or a referral for counseling), as needed, (i) to help a recipient cope with the emotional consequences of the test result, (ii) regarding potential discrimination in the event of disclosure of the test result, or (iii) regarding behavior changes to prevent transmission/contraction of HIV infection. This legislation states that a person communicating an HIV-related test result is still required to offer, as necessary, counseling on (1) available medical treatments and services, (2) local or community-based support services, (3) involvement of the parents or legal guardian of a minor patient concerning the minor’s ongoing treatment, and (4) the need for the patient to notify partners (and where appropriate, assistance in notifying partners). Finally, PA 17-6 removes a previous provision that formerly allowed the subject of an HIV-related test to refuse to receive the test result.
This legislation also makes technical corrections to the Connecticut law governing needle and exchange programs, by recasting such programs as “syringe services programs” and implementing conforming changes to statutes that currently refer to needle and exchange programs. The legislation also mandates that such programs include HIV and hepatitis C outreach in selected communities (in addition to prevention), and states that such programs shall (i) provide access to free and confidential syringe exchanges, (ii) provide for safe disposal and exchange of syringes, and (iii) offer education on the reduction in harm caused by such viruses. PA 17-6 also removes a current requirement that participants in needle exchange programs receive an equal number of needles and syringes for those returned, and clarifies that DPH must require syringe services programs to include an annual evaluation component, which incorporates a determination as to whether there has been a reduction in the incidence of HIV from injection drug use associated with syringe services programs.