Policy Concerning AIDS/HIV
(Acquired Immune Deficiency Syndrome)

INTRODUCTION

The School Committee understands that the best advice from medical specialists today is that Human Immunodeficiency Virus (HIV) can be transmitted through unprotected sexual intercourse, through blood-to-blood contact (such as the sharing of injection drug needles and syringes) and from an infected woman to her baby at or before birth.  The School Committee further understands that a large body of research has demonstrated that HIV is not transmitted through casual contact, such as in a school setting.  Therefore, except in very rare cases, there appears to be no legitimate public health reason to exclude students with AIDS or HIV infection from attending school.

1. STUDENT GUIDELINES AND PROCEDURES

      a. ATTENDANCE

All children diagnosed as having AIDS or with clinical evidence of infection with the AIDS-associated virus (HIV) and receiving medical attention are able to attend regular classes.  However, students who exhibit the following conditions shall not attend school until such time as these conditions are resolved:

  • If a student has weeping or bloody skin or mouth sores that cannot be successfully covered or controlled with medications
  • If the student exhibits biting of an unusual frequency or severity that would be accompanied by actual transfer of blood from the biter, as might happen only from a student with chronically bloody gums or mouth
  • If the student exhibits bloody diarrhea

These conditions are grounds for the exclusion of any student from a school setting, regardless of whether she/he is known or suspected to harbor a blood borne infection.

Children diagnosed as having AIDS or with clinical evidence of infection with the AIDS-associated virus (HIV), who are too ill to attend school, should have an appropriate alternative educational plan.

Siblings of children diagnosed as having AIDS or with clinical evidence of infection with the AIDS-associated virus (HIV) are able to attend to school without any restrictions.

The personal physician of a child diagnosed as having AIDS or with clinical evidence of infection with the AIDS-associated virus (HIV) is the primary manager.

 

Since the child diagnosed as having AIDS or with clinical evidence of infection with the AIDS-associated virus (HIV) has a somewhat greater risk of acquiring infections in the school setting, the child should be excluded from school if there is an outbreak of a threatening communicable disease such as chicken pox or measles, until he/she is properly treated (possible with hyperimmune gamma globulin) and/or the outbreak is no longer a threat to the child.

In physical education classes, intramural activities, recess, interscholastic sports and similar activities, no student shall return to play until all open wounds are covered with appropriate dry dressing.  Regulations recommended by the MIAA Blue Book will be followed.

      b. DISCLOSURE

The student’s parent(s) or guardian(s) are the gatekeepers of information relating to the student’s AIDS/HIV status.  Under Massachusetts law, they are not obliged to disclose this information to school personnel.

However, a student, who is diagnosed with AIDS or presents evidence of being immuno-compromised, is at a greater risk of contracting infections.  This means there may be good reasons for the child’s own protection to inform the school nurse, school physician and the school principal of a student’s AIDS diagnosis or HIV infection status.  This student’s parent(s) or guardian(s) would benefit from information from the school nurse or school physician about the occurrence of threatening contagious diseases (such as chicken pox or influenza) when making a decision regarding school attendance.  The school nurse or school physician may also need to attend to the particular needs of HIV-infected students regarding immunization schedules and medications.

In consultation with the student’s primary care physician, the student’s parent(s) or guardian(s) may decide to inform certain school personnel about the student’s AIDS/HIV status.  We encourage parents to authorize disclosure to the school nurse, the school physician, the school principal and other appropriate staff members, who are in effective positions to aid the child.  If they choose to disclose, the following guidelines are recommended:

  • The student’s parent(s) or guardian(s) may inform the school nurse or school principal directly.
  • Alternatively, the student’s parent(s) or guardian(s) may request that their primary care physician make the disclosure.  In this case, specific, informed, written consent of the student’s parent(s) or guardian(s) is required.
  • Clean up other body fluid spills (urine, vomitus, feces), unless grossly blood contaminated, in the usual manner.  They do not pose a significant risk of HIV infection.

In-service programs for school nurses and other appropriate staff will be conducted as new information becomes available.

  • Further disclosure of a student’s HIV status by the school nurse or school principal to other school personnel requires the specific, informed written consent of the student’s parent(s) or guardian(s).  If and when such consent is given, the letter should spell out specifically, by name, who should be told.  This consent form shall be enclosed in a folder that specifically states who has permission to read it.  This folder, as well as any documents related to a student’s AIDS diagnosis or HIV infection, shall be placed in a separate, locked file.  [Note: M.G.L. c. 111, s. 70F prohibits health care providers, physicians and health care facilities (including school-based clinics) from disclosing HIV test results, or even the fact that a test has been performed, without the specific, informed, written consent of the person who has been tested.  This statute prohibits testing persons for HIV antibodies without their permission, and protects against the nonconsensual release of medical records (including school health records) which contain such information.]
  • Routinely, no HIV/AIDS related medical information shall be placed into a student’s health record.  Due to its accessibility by multiple school staff, specific, informed, written consent shall be obtained from the student’s parent(s) or guardian(s) prior to entering this information into the school health record.  [Note: Private medical notes for example, a student’s personal care physician’s instructions on the administration of medications should be kept in a locked file separate from the school health record and only be accessible to staff who have been given written consent to view them.]

If an adolescent student has sought HIV antibody testing independent of parental consent, that student has the right to keep this information confidential, and any disclosure of this information would require the student’s specific, informed written consent.  [Note: Under state public health statue M.G.L. c. 112 s. 12F, minors may consent to their own dental care and medical testing, diagnosis and treatment in certain circumstances (including HIV infection).  This law mandates confidentiality of medical information and records except when an attending physician or dentist reasonably believes that the condition of the minor is so serious that the minor’s life or limb is endangered.]

2. EMPLOYEE GUIDELINES

  • ATTENDANCE

Wellesley Public School employees with life-threatening illnesses, including, but not limited to, cancer, heart disease, and AIDS may wish to continue to work.  As long as employees are able to meet acceptable performance standards, and medical evidence indicates that their condition is not a threat to themselves or others,

  • employees shall be assured of continued employment.  Federal and State laws also mandate, pursuant to the laws protecting disabled individuals, that those individuals not be discriminated against on the basis of their handicaps, and that if it becomes necessary, some reasonable accommodations be made to enable qualified individuals to continue to work.
  • DISCLOSURE

Under Massachusetts law, staff members who are infected with HIV can decide whether they want their colleagues or students to know about the illness (they are not obliged to disclose this information).  Should school personnel be notified, the same issues regarding confidentiality as described for students will prevail.

Mandatory screening for communicable diseases that are not spread by casual, everyday contact, such as HIV infection, shall not be a condition for school entry or attendance, or for employment or continued employment.

3. UNIVERSAL PRECAUTIONS
           
                       Universal precautions, recommended by the Centers for Disease Control, refer to the usual and ordinary steps all staff and students need to take in order to reduce their risk of infection with HIV, the virus that causes AIDS, as well as other blood-borne organisms (such as the Hepatitis B virus).  This applies to students and staff during all school activities including playground, gym and athletic events.

            They are universal because they refer to steps that will be taken in all cases, not only when a staff member or student is known to be HIV-infected.

            They are precautions because they require foresight and planning, and will be integrated into existing safety guidelines.

            Appropriate equipment (mops, buckets, bleach, hot water, hand soap, disposable towels and latex gloves) will be readily available to all staff members who are responsible for the clean-up of body fluid spills.

  • Treat human blood spills with caution.
  • Clean up blood spills promptly.
  • Inspect the intactness of skin on all exposed body parts, especially the hands.  Cover any and all open cuts or broken skin, or ask another staff member to do the clean-up.  Latex gloves contribute an added measure of protection, but are not essential if skin is intact.
  • Clean up blood spills with a solution of one part household bleach to ten parts water, pouring the solution around the periphery of the spill.  Disinfect mops, buckets and other cleaning equipment with fresh bleach solution.
  • Always wash hands after any contact with body fluids.  This should be done immediately in order to avoid contaminating other surfaces or parts of the body (be especially careful not to touch your eyes before washing up.) Soap and water will kill HIV.
  • Clean up other body fluid spills (urine, vomitus, feces), unless grossly blood contaminated, in the usual manner.  They do not pose a significant risk of HIV infection.
In-service programs for school nurses and other appropriate staff will be conducted as new information becomes available.