Waddell v. Valley Forge Dental Assocs., Inc. 276 F.3d 1275 (11th Cir. 2001)

An HIV-positive dental hygienist who was fired because of his HIV status brought a claim against his employer under Title II of the Americans with Disabilities Act (ADA). The employer raised the ADA’s direct threat exception, arguing that an HIV-positive hygienist poses a significant risk of HIV transmission to patients. Relying in part on the CDC’s 1991 recommendations related to the practice of HIV-positive health care workers, the court found for the employer, concluding that the hygienist performed “exposure prone” procedures and was thus a direct threat to his patients. Despite what was known at the time about the relative risk of HIV transmission, and the protective effect of universal precautions, the court essentially determined that any risk of HIV transmission, no matter how low and regardless of whether it had occurred before, is a significant risk, and consequently that HIV-positive hygienists invariably pose a threat to patients, without regard for the hygienist’s individual skills, health, or work history.