UCLA Study Finds High Rates of HIV Discrimination in Healthcare

LOS ANGELES --  The Williams Institute on Sexual Orientation Law and Public Policy released a study today showing surprisingly high rates of HIV discrimination by healthcare providers in Los Angeles County.  The study reports findings from three "testing" studies of skilled nursing facilities, obstetricians, and cosmetic surgeons conducted between 2003 and 2005. 

Overall, 56 percent of skilled nursing facilities, 47 percent of obstetricians, and 26 percent of plastic and cosmetic surgeons in Los Angeles County would not accept HIV-positive patients for services commonly offered to HIV-negative patients. For example, when asked if he accepted HIV-positive patients, one healthcare worker responded, "We try not to. I'm just trying to be honest."

"The large number of healthcare providers who would readily admit that they would not treat HIV-positive patients is surprising," said Brad Sears, executive director of the Williams Institute and author of the study. "Their responses indicate a broad lack of knowledge about the laws prohibiting such discrimination."

"While the United States has made great advances during the past decade in treating HIV-disease, this study shows that we lag behind in eradicating HIV-discrimination," said Lee Badgett, Williams Institute research director.

The new report is consistent with studies from the mid-1990s showing high levels of HIV-discrimination by dentists and other healthcare providers.  Since the late 1990s, very few studies have been done to measure HIV-discrimination in healthcare.

The studies were conducted by trained "testers," third-year UCLA law students posing as either HIV-positive patients or as employees of organizations working with such patients.  Using a script, the testers called the offices of local healthcare providers and asked if they would accept HIV-positive patients. The testers then recorded and coded the responses.

The three types of healthcare providers included in the study were chosen based on current medical needs of persons living with HIV/AIDS, including nursing care as the HIV-population ages, cosmetic surgery to address the impact of facial wasting, and prenatal care for women living with HIV/AIDS.  The study focused on determining the percentage of providers in each area who had a blanket policy of refusing services to people with HIV/AIDS.

The study also provides insight into why healthcare providers refuse to see HIV-positive patients.  Some providers justified their policies by their lack of expertise or medical equipment, the fact that they had never treated an HIV-positive patient before, or that their staff were inadequately trained or would "revolt" if asked to treat HIV-positive patients.

Many providers follow a blanket policy of referring all HIV-positive patients to other providers, most frequently by just telling them they need a "specialist" or to "go to a hospital." State and federal law require that such referrals be made on a case-by-case basis after providers have gathered specific information about the health and health care needs of the prospective patient.

"Many providers are refusing to treat HIV-positive patients and are referring them elsewhere in violation of the ethical rules of their own professional associations," says Sears. "In a couple of cases,  the testers followed up on the initial referrals, only to be referred on again and again in a frustrating trail that ended with an absolute refusal of care."

"The study indicates that strengthening current laws prohibiting HIV discrimination may not be enough," says Badgett. "We have laws on the books already.  The problem may be inadequate training of heathcare professionals about HIV-disease and their legal obligations, as well as a lack of enforcement."

The Williams Institute on Sexual Orientation Law and Public Policy advances law and public policy through rigorous, independent research and scholarship, and disseminates its work through a variety of education programs and media to judges, legislators, lawyers, other policy makers and the public.

Source: Williams Institute on Sexual Orientation Law and Public Policy

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