HIV and Psychiatric Hospitalization of Children and Adolescents
by the HIV Issues Committee with support from the Sexual Orientation and Gender Identity Issues Committee
Approved by Executive Committee January 2009
To be reviewed 2014
Human Immunodeficiency Virus (HIV) infection or risk of HIV infection is not a reason to deny a child admission to a psychiatric hospital.
All patients admitted to a psychiatric hospital should be treated as if they were HIV infected. Even if all patients were tested on admission for antibodies to HIV, one is still not sure of infection status due to the potential latency period of antibody response documenting infection.
Universal precautions should be employed for any secretions, including blood from any psychiatric inpatient. There is no need for a change in management for an HIV infected child if universal precautions are used for all inpatients.
HIV positive or potentially positive patients do not require individual rooms or toilet facilities. HIV infected, or potentially infected, patients do not need to be isolated in regards to the milieu or peer groups. Such patients should participate in all aspects of the inpatient treatment program.
The Academy supports the 2006 Center for Disease Control recommendation of the adoption of routine HIV testing in all healthcare settings from the age of 13 to 64 years. The testing should be undertaken only with the patient’s knowledge and understanding that HIV testing is planned. Patients can refuse testing. Persons likely to be high risk for HIV infection, including injection drug users and their partners, sex workers, partners of HIV infected persons, and persons who themselves or whose sex partners have had more than one sex partner since their most recent HIV test all should be tested annually. The Child and Adolescent Psychiatrist should balance the adolescent’s request for privacy with the families wishes. There are specific laws regarding confidentiality of HIV antibody testing results and who authorizes consent in minors. These laws vary from state to state. Prior to testing, ensure the laws are understood.
Results of patients' HIV antibody tests will be maintained in a confidential manner. A patient's HIV status should be shared only with those staff who need to know the status to appropriately care for the child while an inpatient. Sharing of HIV status should, of course, be in compliance with applicable state and federal law.
(to be reviewed again in 2014)