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Reporting Requirements for HIV Positive Persons Regulations

made under Sections 74 and 106 of the
Health Protection Act
S.N.S. 2004, c. 4
O.I.C. 2005-457 (October 14, 2005, effective November 1, 2005), N.S. Reg. 197/2005


Interpretation

Citation
1 These regulations may be cited as the Reporting Requirements for HIV Positive Persons Regulations.

Definitions
2 In these regulations,

(a) "Act" means the Health Protection Act;

(b) "agency" means a facility designated by the Minister to provide anonymous HIV testing services;

(c) "AIDS" means Acquired Immune Deficiency Syndrome;

(d) "anonymous testing" means HIV testing

(i) in which results can be linked to the person being tested by a code known only by the person and the counsellor performing the test, and

(ii) that is provided only by counsellors at sites that are specifically designated by the Minister to perform anonymous testing;

(e) "code" means a series of numbers and letters used to replace the name of a positive person in accordance with subsection 9(2) or subsection 11(3);

(f) "counsellor" means an individual who has been hired or designated by an agency to provide anonymous HIV testing services, but does not include a physician;

(g) "donation of blood or other tissues" includes donations, whether for compensation or not, of blood, semen, organs, breast milk, corneas or other tissues or cells, whether replaceable by natural processes of repair or not;

(h) "HIV" means Human Immunodeficiency Virus;

(i) "medical officer" means the medical officer in charge of the locality in which the person responsible for reporting works;

(j) "nominal testing" means HIV testing in which results can be linked to the person being tested by their full name;

(k) "non-nominal testing" means HIV testing in which results can be linked to the person being tested by a code known only by the person and the physician performing the test;

(l) "occupational exposure" means exposure to blood, blood products or body fluids, or [a] sharps injury sustained in the performance of work-related duties;

(m) "partner" means an individual with whom a positive person has, since the probable earliest date of infection of the positive person,

(i) engaged in unprotected anal, vaginal or oral sexual intercourse, or

(ii) shared injection drug use equipment,

or engaged in some other behaviour that, in the opinion of a physician, carries a significant risk of infection with HIV;

(n) "positive person" means

(i) a person who has tested positive for HIV or any of its antibodies, or

(ii) a person whom a physician has diagnosed as having AIDS;

(o) "probable earliest date of infection" means the date determined by a physician, using information from the positive person or other sources, to be the earliest probable date on which the positive person became infected with HIV;

(p) "risk factor" means an aspect of personal behaviour or lifestyle that is known to be associated with HIV infection.

Duties of Physicians and Counsellors

Duty of physician
3 (1) If a physician has a patient who requests to be tested for HIV, the physician must comply with the counselling requirements of Sections 5 and 6.

(2) If a physician has a patient who is a positive person, the physician must

(a) comply with the reporting requirements of Sections 8, 9 and 10 and the partner notification requirements of Sections 12 and 14 in respect of the positive person; or

(b) if the physician is unable to comply with clause (a),

(i) identify a physician who is willing to comply with the requirements of clause (a) in respect of the positive person,

(ii) with the consent of the positive person, transfer responsibility for the positive personís case to the physician identified under subclause (i),

(iii) provide all relevant information about the positive person within the physicianís knowledge to the physician identified under subclause (i), and

(iv) inform the medical officer that the physician has transferred responsibility for the positive person under subclause (ii),

(A) identifying the physician to whom the responsibility for the positive person has been transferred, and

(B) identifying the positive person

(I) by non-nominal code, if the person tested positive by non-nominal testing, or

(II) by name if the person tested positive by nominal testing.

Duty of counsellor
4 (1) If a person requests anonymous testing from a counsellor, the counsellor must comply with the counselling requirements of Sections 5 and 6.

(2) If a person who requests anonymous testing from a counsellor tests positive, the counsellor must comply with the reporting requirements of Section 11 and the partner notification requirements of Sections 12 and 14.

Counselling Requirements

Pre-test counselling
5 (1) Before a physician or counsellor initiates an HIV test, the physician or counsellor must counsel the person to be tested, in accordance with pre-test counselling guidelines approved by the Department.

(2) If a person to be tested for HIV has had an occupational exposure, the physician or counsellor must counsel the person in accordance with occupational exposure guidelines approved by the Department.

Post-test counselling
6 (1) When a physician or counsellor communicates the result of an HIV test to a person, the physician or counsellor must

(a) counsel the person in accordance with post-test counselling guidelines approved by the Department; and

(b) if the person has tested positive, advise the person of the partner notification requirements of these regulations in accordance with Section 12.

(2) When a physician or counsellor communicates the result of an HIV test to a person who has had an occupational exposure, the physician or counsellor must counsel the person in accordance with occupational exposure guidelines approved by the Department.

Physiciansí Reporting Requirements for Nominal and Non-nominal Testing

Request for nominal or non-nominal testing
7 After pre-test counselling, a person seeking an HIV test from a physician must choose either nominal or non-nominal testing.

Reporting of nominal test result
8 If a person who requests nominal testing from a physician tests positive, the physician must report to the medical officer

(a) the name of the positive person;

(b) the risk factors that may have caused HIV infection in the positive person;

(c) the date or dates on which and the location or locations where the positive person may have received blood or other tissues;

(d) the positive personís history of donations of blood or other tissues;

(e) confirmation that all reasonable efforts have been made to notify the positive personís partners in accordance with Sections 12 to 14; and

(f) any additional epidemiological information not included under clauses (b) to (e) that is required in accordance with guidelines approved by the Chief Medical Officer.

Reporting of non-nominal test result
9 (1) If a person who requests non-nominal testing from a physician tests positive, the physician must report to the medical officer

(a) the test result using the non-nominal code in accordance with subsection (2); and

(b) the information required by clauses 8(b) to (f).

(2) The non-nominal code must be composed as follows:

Full date of birth: _ _/_ _ /_ _
day/month/year
(6 numbers)
Gender: _ (1 letter, either M or F)
County where resident: _ _ _ (first 3 letters)
3 letters chosen by person to be tested: _ _ _ (3 letters)

Circumstances for reporting of name
10 Despite any other provision of these regulations, a physician of a positive person must report the name of the positive person and all relevant information obtained from the positive person to the medical officer if

(a) prior to testing positive, the positive person made a donation of blood or other tissues; or

(b) the medical officer, after consultation with the physician of the positive person, is of the opinion that the protection of the public health requires it.

Counsellorsí Reporting Requirements for Anonymous Testing

Reporting of anonymous test results
11 (1) If a person who requests anonymous testing from a counsellor tests positive, the counsellor who provided the test must report to the medical officer

(a) the test result using the anonymous code in accordance with subsection (3); and

(b) risk factor information regarding the positive person in accordance with the guidelines approved by the Department.

(2) If a person tests negative by anonymous testing, the counsellor who provided the test must report risk factor information regarding that person to the medical officer in accordance with the guidelines approved by the Department.

(3) The anonymous code must be composed as follows:

Year of birth: _ _ _ _ (4 numbers)
Gender: _ (1 letter, either M or F)
County where resident: _ _ _ (first 3 letters)
Testing site identification: _ _ (2 numbers assigned by the
medical officer)
Client number of person to be tested: _ _ _ _ (minimum of 4 numbers,
sequentially assigned to
clients by counsellor)

Partner Notification

Advice of requirement for partner notification
12 As part of the counselling provided to a positive person under subsection 6(1), the physician or counsellor of the positive person must advise the positive person about

(a) the positive personís responsibility to inform every partner of the positive person about their risk of exposure to HIV;

(b) partner notification guidelines approved by the medical officer; and

(c) the positive personís ability to transfer responsibility for partner notification under clause 13(b) to a physician or public health nurse who will notify partners on behalf of the positive person.

Responsibility of positive person
13 If a person tests positive for HIV, the positive person must

(a) notify partners in accordance with partner notification guidelines approved by the medical officer; or

(b) transfer responsibility for partner notification to a physician or public health nurse who will notify partners on behalf of the positive person in accordance with partner notification guidelines approved by the medical officer, in which case the positive person must make all reasonable efforts to provide the names and other relevant information about every partner of the positive person to the physician or public health nurse.

Physician required to consult with medical officer
14 Despite Sections 12 and 13, if the physician of a positive person is not satisfied that a partner of the positive person has been informed that he or she is at risk of exposure to HIV, the physician of the positive person must consult the medical officer.