Testing & Privacy | HIV/AIDS | Maine

Yes. Maine law mandates that an HIV test must be “voluntary and undertaken only with the patient’s knowledge that an HIV test is planned” (5 M.R.S.A §19203-A).

Maine, however, has eliminated its requirement that no HIV test may be conducted without a patient’s specific written informed consent.

The law now requires only that “[a] patient must be informed orally or in writing that an HIV test will be performed unless the patient declines”(5. M.R.S.A. §19203-A (emphasis added). While the title of § 19203-A is “voluntary informed consent required,” Maine’s law is not an informed consent system. Informed consent, whether oral or written, requires that a patient affirmatively assent before a test can be done. Current Maine law simply requires that a patient be notified that a test will occur and places the burden on the patient to opt out.)

The law also requires that the information given to patients before the test include the meaning of positive and negative test results. In addition, the patient must have the opportunity to ask questions.

Maine law authorizes anonymous HIV testing sites (5 M.R.S.A. §19203-B).

Health insurers or healthcare plans requiring an HIV test must still obtain written informed consent to perform an HIV test (5 M.R.S.A. §19203-A (2)).

In addition, Maine law prohibits a health care provider from denying medical treatment solely because an individual has refused consent to an HIV test (5 M.R.S.A. § 19203-A (3)).

In 2007, in order to streamline testing procedures, Maine eliminated mandatory pre-test counseling for an HIV test. Patients who test positive for HIV, however, must be offered post-test counseling, unless the patient declines by signing a waiver.  The counseling must at a minimum include:

• The reliability and significance of the test results.
• Information about preventive practices and risk reduction.
• Referrals for medical care and support services, as needed.(5 M.R.S.A. § 19204-A.)

A provider must offer face-to-face post-test counseling, but may provide an alternative means of providing the information if the client declines face-to-face counseling. In addition, a written memorandum summarizing the contents of the post-test counseling information must be provided to the client.

A physician may test a minor for HIV without obtaining the consent of the minor’s parent or guardian.(32 MRSA § 3292 permits a physician to provide medical treatment for venereal disease to a minor without parental consent.  The Maine Department of Human Services has classified HIV as a venereal disease.)

In addition, a physician is not obligated to, but may, inform the minor’s guardian or parent of any medical treatment rendered, including HIV test results.

If confidentiality is important to you, it is a good idea to talk to your doctor up front and understand their policies on this issue.

All pregnant people must be informed orally or in writing that an HIV test will be included in the standard panel of prenatal medical tests, unless the person declines HIV testing.  In addition, a health care provider is mandated to test a newborn for HIV within 12 hours of birth if the health care provider does not know the person who gave birth’s HIV status or “believes that HIV testing is medically necessary.”  There is an exception to such newborn testing if the parent asserts an objection based on religious or conscientious beliefs.(5 M.R.S.A. § 19203-A(6))

Yes, Maine law permits involuntary HIV testing in certain limited circumstances, such as testing of a person convicted of a sexual assault crime, and of the source of an occupational exposure.

Maine law prohibits the disclosure of HIV test results to anyone other than the subject of the test without the subject’s authorization. (5 M.R.S.A. § 19203.)

When a medical record contains a person’s HIV status, the patient must elect in writing whether to authorize the release of that portion of the medical record. (5 M.R.S.A. § 19203-D.)

A health care provider who has been designated by the subject of the test to receive HIV test result information may make the results available only to other health care providers working directly with the patient and only for purposes of providing direct medical or dental patient care.(5 M.R.S.A. § 19203 (2).)

HIV status can still be shared in the event of a medical emergency or certain limited threats to others.

Yes, many courts have found that a person has a constitutional privacy right to the nondisclosure of HIV status.  Courts have based this right on the Due Process Clause of the U.S. Constitution, which creates a privacy interest in avoiding disclosure of certain types of personal information.

The constitutional right to privacy can only be asserted when the person disclosing the information is a state or government actor — e.g. police, prison officials, or doctors at a state hospital.

To determine whether there has been a violation of this right to privacy, courts balance the nature of the intrusion into a person’s privacy against the weight to be given to the government’s legitimate reasons for a policy or practice that results in disclosure.

Remedy for Unlawful HIV Testing or Disclosure

A person who violates Maine law regarding HIV testing or the confidentiality of HIV test results is liable to the subject for actual damages and costs plus a civil penalty of up to $1,000 for a negligent violation and $5,000 for an intentional violation (5 M.R.S.A. § 19206).

Yes. All states require that certain health conditions be reported to public health authorities in order to track epidemiological trends and develop effective prevention strategies. Maine requires that health care providers and facilities report the names of individuals diagnosed with AIDS or HIV to the Department of Health and Human Services within 48 hours of the diagnosis (Department of Health and Human Services, Maine Center for Disease Control & Prevention, Chapter 258 (Rules for the Control of Notifiable Disease Conditions), 10-144). Information is kept confidential and may not be disclosed except as permitted by 5 M.R.S.A. § 19203 (Maine’s law on confidentiality of HIV tests).