HIV/AIDS Counseling & Testing in Maryland

	News & Events NEW! 2008 Changes in HIV/AIDS Counseling and Testing Laws: Notice to HealthCare Providers 2007 Physician toolkit on changes to HIV/AIDS reporting law

2008 Changes in HIV/AIDS Counseling and Testing Laws

Effective July 1, 2008, Maryland law has modified the HIV testing process in the areas of:

• Obtaining Informed Consent for an HIV test;
• Providing Pre-Test Counseling;
• Providing Test Results and Referrals (Post-Test Session);
• Notifying Sexual and Needle Sharing Partners; and
• Working with Pregnant Women.

For more detailed description, please view the

PRACTICE ADVISORY FOR HIV TESTING PROCESS IN MARYLAND

It is important to note that although the Centers for Disease Control and Prevention (CDC) has issued guidelines on HIV testing in healthcare settings, those recommendations do not supersede Maryland law and regulations. If there is any incongruence between CDC's recommendations and Maryland law, State law must be followed.

Please visit the Maryland AIDS Administration's Website for more information on the Legislation.

2007 Changes in HIV/AIDS Reporting Law: What Providers Need To Know

Each year, Maryland receives federal funding for HIV/AIDS services from the Ryan White CARE Act. In Maryland, while AIDS cases are reported by name, HIV cases have been reported by unique identifier since 1994. Beginning this year, federal funding will only be distributed to states that either report HIV/AIDS cases by name, or are in the process of transitioning HIV reporting to be in line with AIDS name-based reporting.

The Maryland General Assembly passed the Maryland HIV/AIDS Reporting Act in April 2007, which requires name-based reporting of HIV cases, and allows the state health department to take the necessary steps to ensure that Maryland will continue to be eligible to receive federal funds for HIV/AIDS services.

Legislation

The Maryland HIV/AIDS Reporting Act passed by the General Assembly enacts the following five changes:

1. Physician reporting has been expanded from AIDS cases by name to both HIV and AIDS cases by name.
2. Institutions (including hospitals, nursing homes, hospice facilities, medical clinics in correctional facilities, inpatient psychiatric facilities, and inpatient drug rehabilitation facilities) are required to report both HIV and AIDS cases by name.
3. Laboratory reporting has been expanded from HIV positive tests and CD4+ lymphocyte counts <200 cells to include all CD4+ lymphocyte tests. Reporting has been changed from unique identifier code to name.
4. Physician reporting has been expanded to include exposure of newborn infants to HIV. Identifying information will be removed after 18 months if the infant is found to no longer be HIV positive.
5. Increased restrictions on access to HIV/AIDS data and heightened penalties for intentional release of confidential HIV/AIDS data have been added.

Effect of Proposed Changes on Health Care Providers

Physicians and health care institutions are now obligated to report all HIV and AIDS cases by name to the health department. Only complete cases, reported by name, will be counted for federal funding of local HIV prevention, care, and treatment programs. Providers are strongly encouraged to inform their patients about the changes to the reporting law, and consent must be obtained prior to HIV testing.

How to report HIV/AIDS Cases

The morbidity reporting form used by physicians, healthcare institutions, and other services providers to report all communicable diseases (DHMH Form 1140) was changed to add HIV, along with AIDS, as a reportable condition; each case report should be submitted by the provider to the local health officer within 48 hours.

Physician Toolkit: Changes in HIV/AIDS Reporting Requirements

Updated Forms

• Maryland DHMH Confidential Morbidity Reports (Instructions)  (PDF)
• Maryland Confidential Morbidity Report (DHMH 1140)  (PDF)
• Informed Consent and Agreement to HIV Testing (English and Spanish)  (PDF)
• Perinatal HIV Authorization Form  (PDF)

Patient Education Material

• Patient brochure: HIV/AIDS Reporting  (PDF)
• Patient brochure: Partner Counseling and Referral Services  (PDF)

Additional HIV/AIDS Materials

• Maryland Epidemiological Profile (PDF)
• HHS Fact Sheet: Testing HIV Positive - Do I have AIDS?
• Centers for Disease Control and Prevention
• CDC HIV/AIDS Fact Sheet (PDF)

For more information about the changes to HIV reporting, visit:

• The Maryland AIDS Administration 

Preventing Perinatal HIV Transmission

In past years, an estimated 92% of AIDS cases reported among children less than 13 years old in the US, were attributed to perinatal or mother-to-child transmission of HIV. Transmission can occur during pregnancy, labor, delivery or breastfeeding. Recent reductions in perinatal transmission are attributed to routine screening of pregnant women to identify those infected with HIV and the use of anti-retroviral drugs for treatment and prophylaxis. Rates of HIV transmission from an infected mother to her infant have been reduced to less than 2%, compared to 25%-30% with no interventions.
The Baltimore Regional Perinatal Advisory Group (RPAG) works to optimize the health of pregnant women and newborn infants in the Baltimore region through education, advocacy and information sharing. RPAG has developed “Preventing Perinatal HIV Transmission: A Clinician’s Toolkit for Testing Counseling and Referral.”

Resources

• Preventing Perinatal HIV Transmission: A Clinician’s Toolkit for Testing Counseling and Referral
• CDC’s Perinatal HIV/AIDS Fact Sheet
• Centers for Disease Control and Prevention

Contact Information

For more information on HIV/AIDS Counseling and Testing in Maryland, please contact:

Robyn Jones, M.P.H.
Program Coordinator
Phone: 410-539-0872 or 800-492-1056, ext. 332
Fax: 410- 649-4131
e-mail: rjones@medchi.org