University of Maryland, College Park Policy and Procedures Concerning HIV Infection and Aids

University of Maryland at College Park recognizes that current knowledge indicates that a person with any form of Human Immunodeficiency Virus (HIV) infection does not pose a direct or indirect health risk to other students or employees in an academic setting or related activities which involve only casual, non-intimate contact. The University views this illness as a serious social and personal tragedy, and seeks to address all ramifications of this policy with sensitivity toward all who may be involved or affected. Every effort will be expended to avoid the influence of false or ill-founded prejudices on official actions, or the tolerance of any personal harassment toward an individual who is affected by the disease.

The following guidelines are based on the best currently available medical information and are compatible with statements by the United States Public Health Service and the Centers for Disease Control and the American College Health Association (ACHA). All matters relating HIV infection including, but not limited to, AIDS education, testing, and counseling shall be the responsibility of the Director of the University Health Center.

1. Application
   
   These guidelines shall apply to all UMCP students and employees.
2. Admissions to the University
   
   The existence of any form of HIV infection/ AIDS infection shall not be considered in the initial admission decision for any otherwise qualified person applying to attend the University.
3. Attendance
   
   Students with HIV infection, whether they are symptomatic or not, shall be allowed regular classroom attendance without restriction as long as they are physically able to attend class.
4. Access to Facilities
   
   Students and employees with HIV infection shall not be restricted from the use of any facilities including the student union, theaters, restaurants, snack bars, gymnasiums, swimming pools, saunas, recreational facilities, or other common areas.
5. Residential Housing
   
   Decisions about housing for students with HIV infection shall be made on a case by case basis based on the best currently available medical information and in consultation with the Director of the University Health Center. Particular concern shall be paid to the psychosocial, emotional and social welfare of the infected student and his or her roommates or suitemates.
   
   The provision of clinical services for those infected shall include consideration of medical history, medical and psychological follow-up, the possibility of HIV people more easily contracting contagious diseases, and the special requirements needed for immunizations for persons with poorly functioning immune systems.
6. HIV Antibody Testing
   
   The University of Maryland at College Park has no mandatory HIV testing requirements. No attempt to identify a person's HIV status will be made either as a precondition for employment or for enrollment in an academic program.
   
   Confidential or anonymous HIV testing, including pre/post test counseling, will be provided (or appropriate referrals made) to students, faculty and staff at the University Health Center. Additionally, educational materials, programs and access to other campus and community resources will be made available through the University Health Center.
7. Confidentiality of Information
   1. Standards
      
      The University shall follow the American College Health Association's guidelines (except as noted elsewhere in the policy) as follows:
      
      "In general, it is recommended that no specific or detailed information concerning complaints or diagnosis be provided to faculty, administrators, or even parents, without the expressed written consent of the patient in each case."
   2. Release of Information
      
      Except as otherwise required by law or court order, no person, group, agency, insurer, or institution shall be provided any medical information of any kind without the prior written consent of the patient.
   3. "Need to Know"
      
      The number of people within the University who are aware of the existence and/or identity of students or employees who have the HIV infection should be kept to minimum in order to protect the confidentiality of and privacy of infected persons, and avoid the generation of fear and anxiety among other students and staff. There is no medical necessity to advise other students living in the same residence halls, classroom, or other shared facility of the presence of students or employees with HIV infection.

The Department of Environmental Safety is responsible for ensuring that each department abides by federal, state and local regulations pertaining to blood and body fluids. The Department of Environmental Safety will work with the University Health Center to access current information in the form of pamphlets, audiovisual aids and outreach educational programs.

Each department is responsible for ensuring that all employees, including newly assigned personnel, faculty and students, receive HIV information and safety precautions guidelines/procedures appropriate to the employee's responsibilities.

Each research laboratory will maintain current policies and procedures pertaining to universal blood and body fluid precautions. A policy for the proper disposal of needles, syringes and other contaminated equipment, issued by the Department of Environmental Safety should be supplemental with additional requirements specific to each laboratory setting.

1. Universal Blood and Body Fluids Precautions
   
   The following universal precautions are to be used at the University Health Care Center with all patients where the potential for blood/bodily fluids exposure exists as described below. Body fluids to which Universal Precautions apply include:
   
   • body fluids containing visible bloodcerebrospinal fluid
   • semen and vaginal secretionspleural fluid
   • internal tissuespericardial fluid
   • synovial fluidamniotic fluid
   • peritoneal fluid
   
   1. Gloves should be worn for touching blood and bodily fluids, mucous membranes, or non-intact skin of all patients, for handling items or surfaces soiled with such fluids, and for performing laboratory procedures, housekeeping tasks involving potential contact with such fluids, venipuncture and other invasive procedures. Gloves should be changed after contact with each patient and hands should be washed. Masks and protective eyewear or face shields should be worn during procedures that are likely to generate droplets of blood or other body fluids to prevent exposure of mucous membranes of the mouth, nose and eyes. Gowns or aprons should be worn during procedures that are likely to generate splashes of blood or other body fluids.
   2. Hands and other skin surfaces should be washed immediately and thoroughly following contact with blood and or other body fluids/substances. Hands should be washed immediately after gloves are removed. If a person has a significant exposure to another person's blood or body fluids which are potentially infectious (as cited above), follow UHC guidelines pertaining to blood or bodily fluids.
   3. All health-care workers should take precautions to prevent injuries caused by needles, scalpels, and other sharp instruments or devices during procedures; when cleaning used instruments, during disposal of used needles, and when handling sharp instruments after procedures. To prevent needlestick injuries, needles should not be recapped, purposely bent or broken by hand or removed from disposable syringes. Tubex syringe holders should be avoided as studies indicate significant increased needlesticks when using such devices. Needles, scalpel blades, and other sharp items should be placed in puncture-resistent containers for disposal.
   4. Puncture resistant containers should be located in all areas where patient care is provided. The method of disposal for these containers as well as all other biological hazardous wastes is into labeled hazardous waste bags and placement into appropriate fiber cartons for shipping/incineration off campus. These wastes are never to be disposed of in the general trash disposal system. Areas such as laboratory have additional disposal requirements.
   5. To minimize the need for emergency mouth-to-mouth resuscitation, mouthpieces, resuscitation bags, or other ventilation devices should be available for use in areas in which the need for resuscitation is predictable.
   6. Health-care workers who have exudative lesions or weeping dermatitis should refrain from all direct contact with patient care without gloves and from handling patient care equipment without gloves until the condition resolves.
   7. Pregnant health-care workers are not known to be at greater risk of contracting HIV or HBV infection than other health care workers. Pregnant health-care workers should be familiar with and strictly adhere to precautions to minimize the risk of HIV or other blood-borne infections as should every health-care worker.
2. Protocol for Treatment After an Exposure to Potentially Infected Blood/Bodily Fluid
   1. Indications for Testing
      1. Anyone who has parenteral (needle stick or cut) or mucous membrane (splash to the eye or mouth) exposure to blood or other body fluids.
      2. Anyone who has any skin contact involving large amounts of blood or prolonged contact with blood, especially when the exposed skin is chapped or abraded.
   2. Testing Procedures
      1. Within as short a time as possible after blood exposure (especially due to the urgency of prompt initiation of drug therapy) a person should select a physician. The physician, either a UHC physician, a private physician or Health Department Physician, will arrange for appropriate medical treatment, provide or arrange for HIV pretest counseling and test results, provide medical follow-up and educational and counseling needs and referrals as indicated.
      2. It is recommended that an exposed person have a voluntary baseline test for hepatitis and HIV as soon as possible after an exposure. It normally takes two (2) to twelve (12) weeks following exposure for the body to produce antibodies to the HIV sufficient to show up in testing. Follow-up HIV testing is recommended at three (3), six (6) and twelve (12) months following a significant exposure. 
      3. For Worker's Compensation purposes, it is recommended that employees obtain a baseline HIV test immediately so that it is recorded in the event that it becomes necessary to show proof that HIV or other infection occurred as a result of job-related exposure. If the test results are negative, the employee should be retested at appropriate three month intervals after exposure.
      4. At this time, specimens collected for HIV testing will be sent to the Maryland State Laboratory for analysis.
      5. Anonymous HIV testing may be done either at the University Health Center or at Prince Georges's County Health Department.
   3. Recommended Procedures to Follow After Exposure
      1. Wash the exposed area thoroughly with your usual cleansing agent except eyes or mouth, which should be rinsed thoroughly with normal saline or water.
      2. Notify the shift supervisor/physician of the incident for further medical direction (tetanus toxiod, Hyperimmune globulin or other medication as recommended refer to MDHD 12/90) Hepatitis B vaccine may be initiated at this time.
      3. Inform the person who was the source of contamination, that his/her being tested for Hepatitis and HIV will be valuable to the person exposed. In no way should the source person be made to feel harassed or coerced into being tested.
      4.  If the source person and/or the person exposed agree(s) to testing, the person should:
         
         • Receive pretest counseling covering information on the HIV and Hepatitis information sheets.
         • Sign the HIV consent form.
         • Set up an appointment for results and additional testing/counseling needs.
         • Obtain blood test(s) using proper procedure to maintain requested confidentiality or anonymity. A source person who refuses to be tested should indicate so on the consent form and sign the consent form where indicated.
         • Complete the following forms: Health Center Incident Report by the end of the shift. Supervisor's First Report of Injury within 72 hours. HIV Testing Info/Consent Form after counseling. Employees First Report of Injury call Occupational Health.

Note: The Health Center follows the current Department of Health and Mental Hygiene Management Recommendations After a Significant Blood/Body Fluid Exposure.