This chart summarizes the guidelines and policies currently in place regarding HIV-positive health care workers (HCW) in all 50 states, as well as some U.S. territories. For each state, the chart includes any relevant guidelines, statutes, or regulations, as well as definitions of "HCW" and "invasive procedure," adopted by the state. It also includes information on the state's policy related to testing HCWs for HIV, notification of patients, and implementation of restrictions on the practice of HIV-positive HCWs.
The guidelines, statutes, and regulations referenced in this document were adopted between 1991 and 1993 in response to a CDC directive that was eventually codified. In the 15 years since these policies were put in place, the limited ways in which HIV transmission is a genuine risk, and the absence of such risk to health care patients, has been solidly confirmed. Moreover, these policies contradict the CDC's public acknowledgement of, and efforts to reduce, HIV-related stigma. The CDC has stated that “the stigmatization of persons infected with HIV and the groups most affected by HIV . . . is a barrier to testing.” (See 49 MMWR 1062 (Dec. 1, 2000)). Yet the CDC has issued, and maintained for more than 15 years, a policy that overtly stigmatizes HIV-positive HCWs, sometimes even at the expense of testing.
In 2000, Professor Larry Gostin called for a revision of the national policy restricting the practices of HIV-positive HCWs, concluding that such a policy is not necessary because of the negligible risk of HIV transmission from HCW to patient. Gostin also asserted that, because the policy unnecessarily stigmatizes HIV-positive HCWs, some HCWs might avoid or delay testing, or leave the medical profession altogether. (See Lawrence O. Gostin, A Proposed National Policy on Health Care Workers Living with HIV/AIDS and Other Blood-Borne Pathogens, 284 JAMA 1965 (Oct. 18, 2000)). Gostin continues to call for a revision of the national policy today.