N.J. Admin. Code § 8:61-4.2

Current through Register Vol. 57, No. 1, January 6, 2025

Section 8:61-4.2 - HIV screening of pregnant persons as part of routine prenatal and perinatal care

(a) A health care provider who is either the primary care provider or the prenatal care provider for a pregnant person shall:

1. Inform the pregnant person, by spoken discussion and/or written or visual media, such as brochures or videos, and in adherence to the Testing Recommendations, of:

i. The fact that testing for HIV, as part of the routine panel of prenatal tests, is recommended for all pregnant persons in each pregnancy, to occur early in a pregnancy and during the third trimester, and that the pregnant person will receive HIV tests, unless the pregnant person specifically declines to be tested for HIV;

ii. The benefits of being tested for HIV as early as possible in the course of the pregnancy and a second time during the third trimester;

iii. HIV infection and the ways in which HIV infection is transmissible;

iv. The meanings of positive and negative HIV test results and the possible need for additional testing to confirm a test result;

v. The medical treatment available to treat HIV infection if diagnosed early;

vi. The reduced rate of transmission of HIV to a fetus if an HIV-infected pregnant person receives treatment for HIV;

vii. The interventions that are available to reduce the risk of transmission of HIV to the fetus and newborn, such as the use of antiretroviral medications, scheduled cesarean delivery, and avoidance of breastfeeding; and

viii. The confidentiality protections applicable to patients' HIV-related information pursuant to the Act and other laws;

2. Offer the pregnant person an opportunity to ask questions;

3. Perform an HIV test on the pregnant person as early as possible in the pregnancy, and again during the third trimester, unless the pregnant person either:

i. Has an existing diagnosis of HIV infection; or

ii. Specifically declines, in spoken or written form, to receive an HIV test;

4. Annotate in the pregnant person's medical record:

i. The date on which the health care provider conveys to the pregnant person the information at (a)1 and 2 above;

ii. If the pregnant person specifically declines to receive an HIV test, the fact that the pregnant person declined (and, if the pregnant person declines, in writing, maintain as part of the record the pregnant person's written declination);

iii. The dates on which the health care provider performs each HIV test; and

iv. The results of each HIV test and HIV-related test that the health care provider performs; and

5. Give the pregnant person the test results.

(b) A health care provider or responsible party for an institution providing care to a pregnant person, shall report a case to the Department using the Adult HIV Confidential Case Report Form Case Report Form, in accordance with N.J.A.C. 8:65, within 24 hours of:

1. Diagnosing HIV, HIV infection, or an HIV-related illness;

2. Receiving a laboratory test result indicating the presence of HIV, HIV infection, or a microorganism indicative of an HIV-related illness; or

3. Receiving a patient's self-report of an existing HIV diagnosis, HIV infection, or HIV-related illness.

(c) In accordance with the Testing Recommendations, a health care provider need not use, and the Department discourages the use of, a form or procedure to obtain a pregnant person's informed consent to HIV testing that is different or separate from, or in addition to, the health care provider's standard form and/or procedure to obtain informed consent to treat the patient and/or to perform other routine perinatal laboratory tests, provided the health care provider informs the patient that an HIV test will be performed as part of the health care provider's routine diagnostic screening and evaluation of the patient, and unless the patient declines an HIV test.

(d) A health care provider who is either the primary care provider or the prenatal care provider for a pregnant person shall not deny a pregnant person appropriate prenatal or other medical care because the pregnant person declines to be tested for HIV.

(e) If a pregnant person, for whom a health care provider is either the primary care provider or the prenatal care provider, has an existing diagnosis of HIV infection or tests positive for HIV infection, the health care provider shall:

1. Counsel the pregnant person as to the implications of the existing HIV diagnosis, or the significance of the test results, with respect to the health of the pregnant person and the potential for the transmissibility of HIV infection to the fetus;

2. Recommend immediate comprehensive medical assessment and treatment for the pregnant person and interventions to prevent transmission to the fetus, in accordance with the Perinatal HIV Clinical Guidelines; and

3. Initiate referrals of the pregnant person to health care providers, health care facilities, and other resources through which the pregnant person can receive HIV care, counseling, and other clinical and social services, as appropriate under the circumstances.

i. Referral resources are available from the Department's 24-hour hotline at (800) 624-2377 and website at http://www.njhivstdline.org, and from the CDC National Prevention Information Network (NPIN) website at https://npin.cdc.gov.

N.J. Admin. Code § 8:61-4.2

Adopted by 57 N.J.R. 29(a), effective 1/6/2025