Guidelines for employees with HIV, AIDS - from the American College of Occupational and Environmenta

Author: Carrie Morantz, Brian Torrey
Date: Sept 15, 2002

The American College of Occupational and Environmental Medicine (ACOEM) has issued guidelines for dealing with human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS) in the workplace. The recommendations appear in the June 2002 Journal of Occupational and Environmental Medicine.

The recommendations address the role that physicians have within the context of the Americans with Disabilities Act of 1990 (ADA) and the Family Medical Leave Act of 1993 (FMLA). They also address issues specific to the health care industry, such as infected health care workers, exposure prevention, handling sensitive medical information, and prophylactic therapy.

Among the guidelines is a recommendation that a physician who performs preplacement medical examinations should ask newly hired employees if they are able to perform the essential functions of the job and determine whether any accommodations are necessary. The physician should not ask about HIV status, and HIV serologic screening should not be undertaken.

If an employee reports that he or she has AIDS or HIV, "reasonable accommodations" required by the ADA might include modifying facilities, restructuring jobs, changing schedules, or transferring marginal functions to another employee. The physician should work with administrative personnel to make sure that the accommodations are appropriately implemented but should not reveal the employee's health condition.

Health care workers who are infected with HIV or AIDS always should practice standard precautions, and workers who perform invasive procedures should know their own HIV status. The ACOEM does not recommend notifying patients of a health care worker's HIV status unless the worker has exposed the patient to the virus.

Physicians in practice settings where employees have potential bloodborne exposure should promote workplace education efforts that address standard precautions, proper use of medical devices, and procedures for immediate exposure triage.

Health care workers exposed to HIV-positive patients should be given retroviral medications and monitored for specific side effects associated with the medications. Prophylaxis should be administered for four weeks. Serologic follow-up to determine whether HIV seroconversion has occurred should be performed at six weeks, three months, and six months following exposure.

COPYRIGHT 2002 American Academy of Family PhysiciansCOPYRIGHT 2002 Gale Group

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