The symptoms pointed to a possible diagnosis of HIV/AIDS for Dr. Tracy Macpherson’s teenage patient. Prolonged fever. Unexplained rash. And acknowledgment of risky sexual activity during the past few months.
Macpherson sent the teen for an HIV/AIDS test at the county health department.
But a state law requiring that HIV/AIDS test results be reported to a student’s school stopped the teen in his tracks.
“He wouldn’t get tested because they were going to tell his (superintendent) and school nurse the results of the test,” Macpherson said. “I couldn’t believe there was such a requirement. This law prevented a patient of mine from seeking medical care on something so critical as HIV. It’s outrageous.”
That might change under a bill filed by Macpherson’s husband, Sen. Brad Hutto, D-Orangeburg.
The bill, which already has passed the Senate and is scheduled for House debate this week, would eliminate the requirement that the Department of Health and Environmental Control notify a school district superintendent and school nurse if a minor tests positive for HIV/AIDS.
HIV/AIDS is the only disease the state health department is required by law to report to schools. Schools are required to report a range of infectious diseases — from tuberculosis to meningitis — to the state health department.
At the end of 2006, 113 South Carolinians ages 13 to 19 were living with HIV/AIDS, according to the state health department. That is less than one half of 1 percent of the 208,000 13- to 19-years-olds in the state’s public schools.
A STIGMA
Hutto’s bill has the backing of many South Carolinians living with HIV/AIDS, including Crystal Hilton, 20.
When word somehow got out that she was HIV positive, other middle school students began teasing her, Hilton said. And, she added, some teachers treated her differently.
State law specifically says only the superintendent and school nurse are to be notified if a student is HIV positive. But others in the school often find out, too, says Hilton.
“Because they knew, the teachers and everyone looked at me differently and judged me,” said Hilton, who was born with HIV. “They didn’t think other students were safe with me in the school. It’s really none of the school’s business.”
School administrators are prohibited from telling others about a student’s HIV status.
“It’s superfluous information that (superintendents and nurses) can’t act upon,” Hutto said. “They can’t notify another student or teacher or parent. They can’t send the student for counseling. It’s knowledge that has no purpose. So why have it at all?”
But Rep. Kris Crawford, R-Florence, an emergency room doctor, says superintendents and nurses need to know because of fights, collisions on the football field and other school mishaps where multiple students bleed.
HIV/AIDS can be passed from one person to another through blood.
In those instances, a student who may have been exposed to HIV should be rushed to the emergency room for medication, which can lessen the likelihood of transmission, Crawford said.
“There are a lot of cuts, abrasions, bruises, everything on the football field,” said Rep. Jeff Duncan, R-Laurens, a former Clemson football player. “Someone at the school needs to know if a student has HIV as a precaution. Then they can direct students who may have been exposed to go to the hospital and get those drugs that reduce the chance of them getting HIV.”
Next week, Crawford, with the support of Duncan, will recommend a change to Hutto’s bill, requiring the state health department to notify superintendents and school nurses if a student tests positive for not only HIV/AIDS but also other blood-borne communicable diseases including hepatitis B and C.
To satisfy Hutto’s concerns about students’ identities, the infected student’s name would not be released, under Crawford’s bill. Instead, school officials would be told an unnamed infected student attended a specific school.
If there was a fight or other situation where multiple students were bloody, the school nurse would contact the state health department to determine if any of the students involved has a communicable disease.
TAKING PRECAUTIONS
But Macpherson said it should not matter whether a student has HIV, hepatitis or any other illness.
Universal medical precautions require school officials to wear medical gloves when treating any student who is bloody.
“You should assume that everyone is HIV positive in any kind of instance involving blood,” Macpherson said. “Otherwise, you give the school nurse a false sense of security that if someone is HIV positive, she knows about it. But that’s not true. Most kids aren’t going to get tested. She’s most likely not going to know who has it. The student is most likely not going to know either.”
The current law also raises serious privacy concerns, Hutto said.
“It’s a walking HIPAA lawsuit,” Hutto said, referring to the 1996 Health Insurance Portability Accountability Act, which limits who has access to an individual’s health information. “The first time someone inadvertently reveals this information, everyone who touches it will have a problem.”
The requirement the state health department notify schools if a student has HIV/AIDS was adopted in 1988, when far less was known about HIV and how it was spread, and before HIPAA.
“It represents the fear and hysteria which was present at that time,” said Bambi Gaddist, executive director of the S.C. HIV/AIDS Council. “But we have come far in understanding how you get it and how you don’t. Knowing what we know now makes this law obsolete.”
Source: The State
WHAT TO DO NOW?