Study: HIV discrimination rampant in Los Angeles County health care

Los Angeles County health care providers show high rates of HIV discrimination, reports the Williams Institute on Sexual Orientation Law and Public Policy at the University of California, Los Angeles.

In three studies conducted between 2003 and 2005, third-year law students, posing as patients who were HIV-positive or organizations working with HIV-positive patients, telephoned health care providers and asked if they treated HIV-positive people, then recorded and coded the responses.

Overall, 56% of skilled nursing facilities, 47% of obstetricians, and 26% of plastic and cosmetic surgeons in Los Angeles County would not accept HIV-positive patients for services commonly offered to HIV-negative patients. When asked if he accepted HIV-positive patients, one health care worker responded, "We try not to. I'm just trying to be honest," according to the institute’s press release.

The types of health care providers were chosen based on current medical needs of persons living with HIV/AIDS, including nursing care for aging HIV population, cosmetic surgery to address facial wasting, and prenatal care for women living with HIV.

"The large number of health care 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, in a press release. "Their responses indicate a broad lack of knowledge about the laws prohibiting such discrimination."

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 were some common justifications for the discriminatory behavior.

Frequently, providers would tell a caller that they need a “specialist” or to “go to a hospital.” However, state and federal law requires referrals not be a standard practice but made on a case-by-case basis after providers have gathered specific information about a 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."

Studies done in the mid 1990s showed high levels of HIV discrimination by dentists and other health care providers.

Lee Badgett, Williams Institute research director, said in the release: "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.” (The Advocate)

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