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Effective: 7/6/2026

G1.19 HIV/AIDS

Legal Authority

Introduction

​​​​​​​​​​​​​​​​​​​​​​​Human immunodeficiency virus (HIV) is a progressively debilitating disease, but proper treatment can significantly delay the onset of acquired immunodeficiency syndrome (AIDS).  The Department for Community Based Services (DCBS) has a responsibility to clients and strives to provide services to HIV-infected individuals while maintaining awareness of the agency's risk and liability to other clients and personnel. DCBS has the responsibility to respect HIV/AIDS clients’ confidentiality. DCBS also advocates for the rights of an infected individual to attend daycare, preschool, school, adult day care, nursing care, or any other needed services under medically and psychosocially appropriate circumstances.

Practice Guidance

HIV/AIDS Testing

HIV testing may not be required of any client. Testing may be considered only for individuals for whom the Cabinet for Health and Family Services (CHFS/Cabinet)  is legally responsible if any of the following risk factors are known:

  • Multiple blood or blood product transfusions between 1978-1985;
  • Children born to a mother known to be HIV infected;
  • Children born to a mother who meets the criteria for HIV exposure;
  • Use of intravenous (IV) drugs;
  • Exhibits symptoms of possible HIV infection.  Symptoms include, but are not limited to:
    • Swollen lymph nodes;
    • Weight loss;
    • Fever;
    • Cough and shortness of breath;
    • Soaking night sweats;
    • Shaking chills or fever higher than 100 F for several weeks;
    • Dry cough and shortness of breath;
    • Chronic diarrhea;
    • Persistent white spots or unusual lesions on your tongue or in your mouth;
    • Headaches;
    • Blurred and distorted vision; or
    • Rare cancer or fungal infections associated with HIV.
    • Has had multiple sexual partners;
    • Has known use of intravenous (IV) drug use;
    • Has hemophilia and has received clotting factor products before April 1985; or
    • Has had sexual partners known or suspected to be infected with HIV or have the above high-risk factors.
  • Testing of a child in temporary or emergency custody requires a court order.
  • When a minor is tested of their own accord and refuses to disclose test results, KRS 214.185(6) allows the medical professional to inform the parent or legal guardian of the minor regarding any treatment given or needed where, in the judgment of the professional, informing the parent or guardian would benefit the health of the minor.
  • Testing for infants and young children may be performed by a pediatric specialist. All other HIV testing may only be performed at testing facilities that offer pre and post-test counseling by specially trained staff. 
  • Pre/post-test counseling services are offered at all local health departments.

Disclosure of HIV/AIDS Status

  • KRS 214.625 strictly prohibits any person who has obtained or has knowledge of a positive HIV/AIDS test result to disclose or be compelled to disclose the identity of any person upon whom a test is performed, or the results of the test in a manner that permits identification of the subject of the test without the written consent of the individual. This is interpreted to include documentation of a positive HIV/AIDS test result within DCBS documents.  The statute does allow the information to be released to the following persons:
    • The subject of the test or the subject's legally authorized representative;
    • Any person designated by the client or their legally authorized representative through a DCBS-1A Informed Consent and Release of Information and Records Supplement;
    • A physician, nurse, or other health care personnel who has a legitimate need to know the test result in order to provide for his protection and to provide for the patient's health and welfare;
    • A health facility or health care provider which procures, processes, distributes, or uses: 
      • Human body part from a deceased person, with respect to medical information regarding that person; or
      • Semen provided for the purpose of artificial insemination;
    • A parent, foster parent, or legal guardian of a minor;
    • Persons allowed access by court order.
  • Disclosure of the confidential HIV status to DCBS personnel may be made on a need-to- know basis, which is based on the optimal care of the client. The Medical Support Section and the regional attorney may be utilized for consultation in situations where disclosure is deemed necessary for the safety and care of the client. 
  • DCBS staff that are responsible for disclosing a client’s HIV status or allowing the HIV status of a client to go beyond those with a legitimate need to know are subject to disciplinary action up to and including dismissal.​

​Placement considerations for children with HIV/AIDS 

  • By law, no child may be denied acceptance to a foster home, group home, or residential facility solely on the basis of HIV infection.  However, the following factors should be considered when selecting the best placement setting to meet the child’s needs:
    • Whether other children in the home or placement setting have behaviors that may increase risk of transmission of the virus such as aggressive or sexualized behaviors;
    • Whether the child with HIV/AIDS infection has aggressive or sexualized behavior that may create risk if placed with other children/youth, and the degree to which the foster parent or residential provider can manage such behaviors;
    • The ability of the foster home or residential provider to meet the needs of a child whose immune system may be impaired including minimizing exposure to childhood diseases and infections from other children.
  • Children with HIV/AIDS have the same right to permanency and adoptive placement as any other child.  


Procedure

The SSW:

  1. Should actively encourage clients who are at risk for infection to be tested;
  2. Consults the regional attorney and the medical support section to test a client without their permission for reasons concerning the client’s health or another individual’s safety;
  3. Consults with the regional attorney, the medical support section, and the child when age appropriate, when a prospective adoptive parent requests to have the child​ tested for HIV/AIDS but does not meet any of the high risk indicators;
  4. Makes arrangements​ for re-testing when appropriate;  
  5. Completes the assessment that includes questions regarding any high risk behaviors in which the client or family may have been involved for any HIV positive client;
  6. Completes a case plan for an HIV infected client that considers the following:
    1. Presence of behaviors likely to transmit the HIV infection;
    2. Potential needs of the client;
    3. Medical status, history, and symptomatology; and
    4. Availability of needed services.
  7. ​Does not disclose the identity of a person who has tested or the results of testing, except to those parties allowed by statute or desingated by the individual in the signed DCBS-1A Informed Consent and Release of Information and Records Supplement; 
  8. Does not document a positive reslult in the DCBS case record, which may be viewed by other staff or reviewers;
  9. Consults witht he regional attorney and the medial support section in situations where disclosure may be necessary for the safety and care of the client;
  10. Clearly documents the regional attorney’s and the medical support section’s decision and reason for any disclosure of information regarding the outcome of a test made without the client’s approval.​
  11. Follows procedures in SOP C7.5 Designation as Medically Complex​ to seek determination regarding medically complex classification upon notification of the child’s HIV/AIDS status if positive; ​
  12. Labels any placement referrals with “Child has serious health care needs” when seeking placement options, seeks appropriate placements in accordance with the child’s medically complex status, and only discloses the child’s HIV status to the foster home or program accepting placement;
  13. Provides additional information on specific health care needs of the child to the care provider once placement has been accepted and the HIV status has been disclosed; 
  14. Regularly monitors the placement to confirm the caregiver’s ability to protect the child with HIV from opportunistic infections, to ensure child is receiving all needed medical services, and to ensure protection of other children in the home;
  15. Does not place a child with a positive HIV status into an adoptive placement until the adoptive parents have been informed of the child’s condition;
  16. Includes HIV/AIDS education in the adoption preparation process or refers the adoptive parents to medical sources for additional information when needed;
  17. Asks the adoptive parent to sign a statement indicating their awareness and understanding of the child’s medical condition prior to finalization of the adoption. 
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Documents

Revisions