Dentists know the vital importance of patient confidentiality, but it’s valuable to revisit how standard confidentiality and patient protections are heightened when it comes to human immunodeficiency virus (HIV) status.

HIV is a virus that attacks the body’s immune system and, if untreated, can lead to acquired immunodeficiency syndrome (AIDS). Patients who are HIV-positive can receive routine dental care, and it’s very important that they keep up with regular appointments because HIV can predispose them to certain oral health problems. The American Dental Association has information on if HIV status affects dental care.

Beyond knowing the standards of care for HIV-positive patients, all dentists and dental staff should know how to address HIV status in the dental record. Here are some of the most frequently asked questions about HIV confidentiality in dentistry.

If a patient advises me that they have risk factors and/or have been tested for HIV, may I include that in my progress notes or the patient history?

Yes, if the patient relays this information as part of their history, or it is medically relevant to their present care and treatment, it may and, in fact, should be documented. However, that record then becomes a protected record under Article 27F of the Public Health Law, which governs the confidentiality of HIV-related information.

May I release records containing HIV information when I receive a subpoena, particularly if it is a judicial subpoena?

The HIV law clearly requires the release of HIV information only with a special HIV consent form or upon receipt of a court order, issued only after a hearing, at which time the patient has had an opportunity to contest the release. A bare subpoena is NOT sufficient.

Does even a negative HIV test result require specific protection of the chart?

Yes, the fact that an HIV test has been done, regardless of the result, raises the possibility that the patient has risk factors for HIV. The patient may sustain harm if this information is released inappropriately.

If a patient tells me prior to dental surgery that they are HIV positive, may I inform the staff who will be involved in the patient’s care?

You may NOT tell the staff if the sole purpose of informing them is infection control, such as having them take extra precautions when caring for the patient. You may tell the licensed staff who are assisting in the dental procedure, only if the disclosure is necessary for the patient’s care and treatment.

Maintaining patient confidentiality around HIV status or tests is vital.

As always, we want to be a resource to you. If you ever have a question about HIV confidentiality in dentistry, MLMIC policyholders can contact a team of risk management professionals 24/7 at no additional cost by calling (844) 667-5291 or emailing hotline@tmglawny.com.

Dental professionals can stay up to date on the latest risk management guidance and alerts by reading The Handbook for Practicing Dentists, monitoring the MLMIC Dental blogThe Scope: Dental Edition and Dental Impressions and following us on Twitter and LinkedIn.

Photo by Artur Tumasjan on Unsplash.