PM 93-11

12/17/93

President Robert C. Detweiler

 

 


University AIDS Policies and Guidelines

[Supercedes PM 86-11]


*Adopted in part from the American College Health Association’s Task Force on the “Acquired Immunodeficiency Syndrome” statement and the Inter-Association Task Force on HIV Infection and AIDS.

 

 

AS OF 1992

 

AIDS is the second-leading killer of American men between 25-44, surpassing heart disease, cancer and suicide.

 

In America, women represent about 11.6% of the total AIDS cases.  There has been a 37% increase in AIDS cases in women over the past year.

 

Worldwide, 75% of all AIDS cases are the result of virus transmission through heterosexual sex.

 

It is estimated that by the year 2000, 55,000 college students in the state of California will be HIV positive.  There is a disproportionately high incidence among ethnic minorities, especially Latinos and African Americans.

 

HIV infection is potentially lethal, but preventable through education.  The primary response by California State University, Dominguez Hills at this time must be education.  The American College Health Association “recommends that the organization and implementation of effective educational programs about AIDS and HIV infection be an activity of the highest priority for all institutions of higher learning.  In designing the format and content of educational programs it is important to recognize and address the rich diversity of people in the campus community and to provide opportunities for effective learning by people of any age, ability, gender, ethnicity, or sexual orientation.”  It is within the context of this philosophy that these policies and guidelines were developed.  In addition, CSUDH policies and guidelines herein contained address all of the policy issues recommended by the Inter-Association Task Force on HIV Infection and AIDS.

 

The following policy and guidelines are provided in order to prevent the spread of the virus, to reduce fears and dispel myths, to protect the rights of persons with the Human Immunodeficiency Virus (HIV), and to create an informed and supportive campus community.

 

The University shall have a capable and well-informed public spokesperson(s), appointed by the President, who can answer questions about the University’s policies on HIV Disease and who is prepared to address the social questions, civil rights issues, and public health considerations surrounding the disease.

 

The University AIDS Committee is the coordinating committee and is charged with planning comprehensive educational programs and developing administrative procedures that address campus issues relating to HIV Disease.  The Committee will coordinate and promote HIV education programs for students, faculty and staff.  The University AIDS Committee will develop and maintain mechanisms which will ensure consistent and reasonable analyses and recommendations for HIV infected persons.  The Committee reports to the Vice President for Student Affairs.

 

Committee members are appointed by the Vice President for Student Affairs and represent a broad University constituency.  (See end of document for membership.)

 

  1. General Policies.  The following policies and guidelines are wide in scope, dealing with students and employees with HIV Disease.  It is important that these policies not become inflexible, irreversible or absolute.  The University must be able to respond to each case as required by its particular facts in a humane, moral, ethical and legal context.

 

  1. Institutional Committee.  The University AIDS Committee, with broad representation (see composition at end), is charged to:

 

                        a.  provide consultations to departments and other similar units upon request either   

                        through its regular membership or sub-committee(s).  The principal purpose of

                        these consultations is to assist units in dealing fairly and rationally with colleagues

                        in the unit that have HIV Disease and to reduce ignorance, fear and anxiety.

 

                        b.  provide centralized coordination of programs and activities associated with HIV

                        Disease.  Persons seeking to offer educational programs for the campus should be

                        provided assistance in terms of referrals, expertise and guidance.

 

            A goal of the University AIDS Committee is to encourage and assist.  The Committee

            in no way will impede other units from presenting programs, courses, workshops,

            applying for grants or participating in other activities relating to AIDS education.

 

                        c.  provide up-to-date HIV educational programs and information containing culturally

                        sensitive material for faculty, staff and student use. Educational programs should

                        be offered on a regular basis.

 

            The subject of HIV Disease and various medical, legal, ethical, political, social, and

            psychological issues arising from the disease are relevant to existing courses in

            health education, health sciences, clinical sciences, social sciences, biology, law,

            general studies and other disciplines.  Faculty are inspirited to incorporate “AIDS”

            topics into the curriculum and are encouraged to call upon the University AIDS

            Committee for assistance.

 

                        d.  work with the President’s designee to maintain a speakers bureau with

                        listings of competent experts in the field of HIV Disease who are known to be in the

                        field of HIV Disease who are known to be sensitive to the needs of the CSUDH

                        constituency.  The listings will include faculty, staff, and community resources.

 

                        e.  work with the President’s designee to network with state and county

                        health agencies and AIDS Centers as appropriate to assure currency and relevancy

                        in the field.

 

                        f.   review the policies and guidelines regarding HIV Disease annually, and report to the

                        appropriate administrative and policy-making bodies.  Urgent developments should

                        be brought to the focus of the campus community in a timely manner.

 

  1. Handicapping Conditions.  Persons with HIV Disease are considered to have handicapping conditions.  The legal rights of these individuals must be maintained and campuses must comply with the Americans with Disabilities Act of 1990.  Existing support services for people with handicapping conditions will be appropriately and effectively utilized by students or employees disabled by HIV infection.  The University will reasonably accommodate students and employees with HIV Disease in a manner consistent with those provisions normally afforded individuals with other medical problems.

 

Students, faculty and staff with HIV Disease are to be given assistance, consistent with other illnesses, in obtaining appropriate medical care, education, counseling and accommodations.  Persons with HIV Disease are considered disabled under state and federal law and should be provided with accommodations necessary to meet their disability-related needs.  A student may be served through state-funded Disabled Student Programs Services if the condition imposes functional limitations that impede access to the educational process.

 

  1. Admissions.  The existence of any form of HIV infection cannot be a consideration in any decision regarding admission to the University nor can it be a consideration regarding employment or performance evaluation.

 

  1. Attendance.  Students who have HIV infection, whether they are symptomatic or not, should be allowed regular classroom attendance in an unrestricted manner as long as they are physically and mentally able to attend classes.

 

  1. Access to Facilities.  There shall be no restriction of access to persons with HIV Disease to University facilities, i.e., residence halls, student housing, educational resources, student union, social, cultural and athletic events, dining areas, gymnasium, swimming pools, recreation facilities, and other common areas.  (This listing is exemplary and not meant as all-inclusive.)

 

Case-by-case decisions should be made with competent medical advice regarding the participation of students with HIV Disease in intramural or varsity sports.  The Athletic Department should be aware of procedures for dealing with blood spills that may result from athletic injuries.

 

7.      Residential Housing.  Decisions about housing for students with HIV infection must be made on a case-by-case basis.  The best currently available medical information does not indicate any risk to those sharing residence with infected individuals.  There may, however, be in some circumstances reasonable concern for the health of students with immune deficiencies (of any origin) when those students might be exposed to certain contagious diseases (e.g., measles or chicken pox) in a close living situation.

 

The Director of Student Housing should obtain and follow the policies suggested by the American College Health Association on accommodating students with HIV Disease in campus housing.  There is no medical or legal necessity to inform other students of the presence of a student with HIV Disease, and to do so could subject the University to liability for violation of the student’s rights.  It is important to provide education on HIV Disease and its modes of transmission to housing students.  Whenever possible and agreed to voluntarily by the affected student, living arrangements should be discussed with a roommate of a student with HIV Disease.

 

8.      Medical Care.  The following pertain to the provision of clinical services to people with HIV infection.

 

                    a. Medical History.  Questions not relevant to medical care are

                    inappropriate.  It is, however, acceptable to encourage students with HIV infection to

                    inform campus health care providers in order to enable them to provide proper medical

                    care, support, counseling, and education.

 

In accordance with existing University procedures and requirements, an employee’s or student’s medical record is confidential information, and such information may not be released without the individual’s permission, except as otherwise provided by law.

 

                    b. Medical and Psychological Follow-Up.  Providers of health services and

                    counseling should make provisions for medical, psychological, and support services

                    which promote the best physical and mental health of persons with HIV infection.

 

The University will provide competent and culturally sensitive counselors and administrators capable of allying fears of employees and students concerned about persons with HIV Disease.

 

Regular medical and psychological follow-ups are to be encouraged for those with HIV Disease.

 

If these services are beyond the scope of the campus, competent practitioners and agencies will be identified who will see students/personnel by referral.  Referrals may be made in confidence if so requested.

 

                    c. Contagious Disease.  Special precautions to protect the health of

                    immunologically compromised individuals should be applied during periods of prevalence

                    of certain casually contagious diseases, such as measles and chicken pox.

 

Persons participating in laboratories in which known pathogens are present, who are immuno-compromised, should carefully consider the risks in consultation with their physician and the instructor of the laboratory.

 

                    d. Immunizations.  Persons known to have immune deficiencies should be excused from

                    institutional requirements for certain vaccinations, especially measles and rubella;

                    these vaccinations may lead to serious consequences in people with a poorly

                    functioning immune system.  Such persons are not required to disclose the nature of

                    their condition, but need only request an exemption for medical reason.

 

Clinicians in the Student Health Center should monitor recommendations concerning other immunizations in persons with HIV infection because of potentially serious consequences of their receiving live virus vaccines.  Some vaccines required for foreign travel may be deleterious to the health of persons infected with HIV.

 

9.          HIV Antibody Testing.

 

                a. Mandatory Testing.  No screening tests (clinical, psychological or

                    laboratory testing) for HIV Disease are to be required by any agents of the University

                    for any purpose.  No individual may be required to answer questions about whether he

                    or she has HIV infection as a condition of admission, employment or enrollment.

 

                 b. Voluntary Testing.  The Student Health Center personnel should be familiar with

                    sources of testing for antibody to HIV, and should be able to refer students or

                    employees requesting tests.  Health care providers should understand the capabilities

                    and limitations of the test, and should be able to counsel and educate persons who

                    seek testing.  Administrators and clinicians must be familiar with state laws and public

                    health requirements regarding charting of results, release of confidential information,

                    and reporting of test results.

 

Whether the tests are performed through the Student Health Center or not, they should be done if and only if:

 

                   1.  they can be confidential or anonymous;

 

                   2.  positive results on the screening test (ELISA test) are confirmed by another

                        procedure; and

 

                   3.  both pre-test and post-test counseling are a mandated part of the program.

 

 

            10.        Confidentiality of Information.  People known or suspected to have HIV infection,

                    whether or not they have symptoms of illness, have sometimes been victims of

                    discrimination and physical or psychological abuse.  The potential for discrimination

                    and mistreatment of these individuals, and of persons thought to be at risk of    

                    infection, requires that confidential information concerning any aspect of HIV infection

                    be handled with extraordinary care.

 

                        a.  Standards.  Guidelines concerning the handling of confidential information about

                        people with HIV infection follow the general standards included in the American

                        College Health Association’s Recommended Standards and Practices for a College

                        Health Program.

 

In general, it is recommended that no specific or detailed information concerning complaints or diagnosis be provided to University personnel, students, and others without the expressed written consent of the patient.  This position with respect to health records is supported by the Family Education Rights and Privacy Act of 1974.

 

                        b. Release of Information.  No person, group, agency, insurer, employer, or

                            institution should be provided any medical information of any kind without the

                            prior written consent of the patient.  Given the possibility of unintended or

                            accidental compromise of the confidentiality of information, health officers

                            should carefully weigh the importance of including any specific information about

                            the existence of known HIV infection in the ordinary medical record except when

                            circumstances of medical necessity mandate it.  At minimum, the inclusion of

                            any information regarding HIV infection in the medical record should

                            be discussed with the patient prior to its entry.

 

                        c. Legal Liability.  Health officials and other institutional officers must remember

                            that all confidential medical information is protected by Statutes and that any

                            unauthorized disclosure of it may create legal liability.  The duty of physicians

                            and other health care providers to protect the confidentiality of information is

                            superseded by the necessity to protect others only in very specific life-

                            threatening circumstances.

 

                        d. “Need to Know.”  The number of people in the institution who are aware of the

                            existence and/or identity of students or employees who have HIV infection

                            should be kept to an absolute minimum, both to protect the confidentiality and

                            privacy of the infected persons and to avoid the generation of unnecessary fear

                            and anxiety among other students and staff.

 

                        e. Informing Other Students or Employees.  These is absolutely no medical or other

                            reason for institutions to advise students living in a residence hall of the

                            presence there of students with HIV infection.  Similarly, officials should not

                            reveal the identity of students or employees with HIV infection in any other

                            setting.  The responsibility to provide a safe living environment is best dealt with

                            by educational programming.  Sharing confidential information without consent

                            may create legal liability.

 

                        f.  Secondary Lists or Records.  Neither health officers nor other administrators

                            should keep lists or logs identifying individuals tested for antibodies to HIV or

                            other tests leading to a presumptive diagnosis or individuals known to be

                            infected with HIV.  The potential for compromise of confidential information far

                            exceeds any conceivable benefit of such listings.

 

                        g. Within legal reporting requirements, confidentiality of medical conditions will be

                            maintained.  The expectation of confidentiality includes all University personnel,

                            faculty, staff and students.

 

    11.      Safety Precautions.  The University will adhere to safety guidelines as proposed by

            the United States Public Health Service for the handling of the blood and body fluids

            of all persons, not just those previously known to have HIV infection.  These

            “universal precautions” are necessary because many people with HIV infection are

            not identified in advance.  The same procedures should thus be followed by handling

            the blood and body fluids of any student or employee.

 

Laboratories.  All laboratories, student and research, in which body fluids are used must conform to the Centers for Disease Control guidelines for “universal precautions.”

 

Field Work.  Students, faculty and staff participating in field work experiences involving body fluids must be instructed on the hazard(s) and provided with protective attire consistent with the guidelines set forth by the California Public Health Service and the Center for Disease Control.

 

Faculty and supervisors should provide educational programs about HIV infection and its transmission to all students and participants in laboratories and field trips in which contact with body fluids is a possibility.

 

    12.   Support Services.  The psychosocial consequences of actual or feared HIV infection 

            are such that students and employees may experience enough suffering to impair

            their health, interfere with academic or work performance, cause extreme

            psychological distress, disrupt plans and cripple relationships.  Support services

            through which concerned persons can receive counseling, assistance in locating and

            using social resources, and referrals for further assistance should be identified. 

            These needs may be met through existing student services or employee assistance

            programs or by identifying community-based resources for referrals.

 

13.  Harassment.  As a result of the fear, anxiety, and anger that many people feel in

       reaction to AIDS, some students or employees who are either known to be or are

            suspected of being infected with HIV may be subjected to emotional and/or

physical abuse.  All such occurrences are intolerable.  University administration

should move quickly and effectively to deal with any incident of harassment or

psychological or physical abuse inflicted on students or employees who may have

or are suspected to have HIV Disease.

 

Refusal to work with a person who has HIV Disease shall not be allowed to excuse an employee from fulfilling assigned responsibilities.

 

14.       Miscellaneous

 

            Child care centers and other similar programs should follow the guidelines

developed by the Centers for Disease Control for education and foster care of

children with HIV Disease.

 

No special precautions beyond ordinary standards of good personal hygiene and

food sanitation are necessary for food service workers.

 

            Appropriate campus personnel (e.g. Student Health Center staff, campus police,

the housing director, key administrators and faculty) will receive training

concerning HIV Disease on a periodic basis.  Training should include such topics

as updated epidemiological data, modes of transmission, cultural and ethnic

concerns, symptoms, and the care and handling of persons with HIV Disease in

crisis.

 

 

 

UNIVERSITY AIDS COMMITTEE MEMBERSHIP

 

Director, Health Programs and Psychological Counseling

            (permanent position, committee chair, provides staff support)

 

One faculty member from each of the Schools

            (recommended by the Dean, two-year term)

 

Two University at-large members

            (appointed by the Vice President for Student Affairs, one-year term)

 

One faculty representative from the Senate

            (elected by the Senate, two-year term)

 

The Associate Vice President for Faculty Affairs or designee

            (permanent position)

 

One staff member, from the Personnel Office*

            (recommended by the Personnel Director, one-year term)

 

One staff member from the Staff Council**

            (recommended by the Staff Council, two-year term)

 

One Associated Student Representative

            (recommended by the ASI President, one-year term)

 

One Student Health Center Representative

(recommended by the Director, Health Programs and Psychological Counseling, one-year term)

 

 

NOTE:  Members are eligible for re-appointment upon recommendation.

 

 

*Currently, the Office of Human Resources Management

**Staff Council no longer exists; staff member is appointed by the President or designee.