It’s not a joke.
Today and tomorrow the Kansas Legislature will consider a bill that would expand the authority of state and local health officials to impose isolation or quarantine on people living with HIV and other infectious diseases. But quarantine statutes are designed for dangerous diseases spread through casual contact, thus presenting a danger to overall public health.
HIV is not transmitted by casual contact, and it makes no sense that people living with HIV must be quarantined or isolated for public health reasons.
The bill as written is offensive, stigmatizing, and does not serve to address any real public health crisis. It perpetuates outdated myths about HIV transmission and people living with HIV. It refers to people living with HIV and other infectious diseases as “afflicted”. There is no public health reason to lock up or quarantine people living with HIV, nor to loosen restrictions on authority to do so.
The bill, Substitute for Kansas HB-2183 will also allow testing of individuals with HIV and other diseases in “occupational exposure” circumstances without consent of the individual and without requiring that a court previously find there is a sound medical basis for the testing.
However, the definition of what may constitute “occupational exposure” is excessively broad, does not include any distinction between, for example, fluids that may transmit HIV and those that do not (e.g. saliva vs blood or semen), routes of exposure that may transmit HIV and those that do not (contact on unbroken skin vs a needle stick), and what type of occupations are being included. Thus there is nothing to prevent a teacher, for example, who has heard a rumor that a parent of her student is HIV-positive, to demand HIV testing of a child who spits on her unbroken skin. This is outrageous.
The Kansas Department of Health and Environment (KDHE) claims that the bill was originally designed to: 1) protect first responders from infectious diseases and 2) reduce HIV stigma by eliminating specific protections for HIV. But according to Catherine Hanssens of the Center for HIV Law and Policy, there has been no documented case of HIV transmission to a first responder in over 30 years of the U.S. HIV epidemic.
The bill permits for HIV testing without consent and says nothing about counseling as part of the testing process, nor does it allude to referrals to any type of medical, mental health, or supportive services that may be needed upon diagnosis of a life-threatening condition. It provides no protections for confidentiality, and in fact, a previous version of the bill may have opened the door for physicians and providers to disclose a patient’s HIV status to partners, spouses, and other providers without her consent.
The substitute bill abridges civil rights and liberties of people living with HIV and other infectious diseases. Substitute for HB-2183 adds the terms “reasonable and medically necessary” as limitations on expanding testing and quarantine authority under the bill. However, the bill fails to define those terms and does not provide a clear standard for what constitutes a “medically necessary and reasonable” restriction.
Write Kansas legislators today to say that the current bill must be rejected or amended consistent with KDHE’s stated intentions and to uphold the rights and dignity of people living with HIV. Please cc: your emails to us so we can track them at: positivewomensnetworkusa(at)gmail.com.
Below is language you can use in your letter. Feel free to cut and paste and add anything in to personalize.
I write to you to express my concern about Substitute for HB 2183. Over thirty years into the epidemic, HIV remains a highly stigmatized disease and recent research demonstrates that there are still significant myths and misunderstandings about modes of HIV transmission, many of which are evident in public policy and practice.
Substitute for HB 2183 as written perpetrates stigma against people living with HIV and does not accurately reflect current medical and scientific knowledge about how HIV is and is not transmitted. It violates the rights of people living with HIV.
Further, it fails in the stated intention to strengthen protections for individuals who may be occupationally exposed to HIV, who should have timely access to post-exposure prophylaxis in those very rare situations where occupational exposure and a risk of transmission may have actually occurred, regardless of a source patient’s test result, because it can take several months after infection before an HIV-positive person’s antibody test is reactive.
In addition, Substitute for HB 2183 does not define which settings occupational exposure is restricted to, thus allowing for any employee in any setting to claim occupational exposure and demand testing under the circumstances where they are exposed to any bodily fluid, including saliva, which does not transmit HIV. Further, the bill does not provide for counseling of individuals who are tested for HIV, referrals to necessary medical and mental health services if they are diagnosed HIV-positive, nor for protections of confidentiality upon diagnosis.
For these reasons, I urge you to reject Substitute for HB 2183 as written, or at minimum to include the following amendments:
– Section 1.E. Add clarifying language that “potentially infectious materials” should reflect current medical and scientific knowledge about the disease being tested for and the mode of exposure.
– Section 2. B. Add that testing should be voluntary and that the secretary of health and environment should clarify the minimum factors required to seek involuntary testing, which must be reasonable and medically necessary, based on current medical and scientific knowledge.
– Section 2. B. Add: “The authority for isolation or quarantine shall not extend to infectious diseases or conditions that do not pose a significant transmission risk through casual contact.”
– Section 2.B. Add: The authority for involuntary testing shall not extend to infectious diseases or conditions that do not pose a significant transmission risk through occupational exposure or casual contact.”
– Section 2.B. Remove the phrase “afflicted with or exposed to such diseases” and replace with “living or exposed to such diseases”
– Section 2.C. Add clarifying language that “potentially infectious materials” should reflect current medical and scientific knowledge about the disease being tested for and the mode of exposure.
– Section 2. Add language to provide for counseling when HIV testing takes place, regardless of test result, protections to assure confidentiality, and referrals to medically necessary services as well as mental health and other services if an HIV test is positive.
Thank you for your consideration.