WAC 246-100-208   Counseling standard -- AIDS counseling.  (1) Principal health care providers shall counsel or ensure AIDS counseling for each pregnant woman continuing the pregnancy. This subsection shall not apply when health care is sought in order to terminate a pregnancy or as a result of a terminated pregnancy. "AIDS counseling" for a pregnant woman means:

     (a) Performing a risk screening that includes an assessment of sexual and drug use history as part of the intake process;

     (b) Providing written or verbal information on HIV infection that at a minimum includes:

     (i) All pregnant women are recommended to have an HIV test;

     (ii) HIV is the cause of AIDS and how HIV is transmitted;

     (iii) A woman may be at risk for HIV infection, and not know it;

     (iv) The efficacy of treatments to reduce vertical transmission;

     (v) The availability of anonymous testing, and why confidential testing is recommended for pregnant women;

     (vi) The need to report HIV infection;

     (vii) Public funds are available to assist eligible HIV-infected women receive medical care and other assistance; and

     (viii) Women who decline testing will not be denied care for themselves or their infants;

     (c) Obtaining the informed consent of the pregnant woman, separately or as part of the consent for a battery of other routine tests provided that the woman is specifically informed in writing or verbally that a test for HIV is included;

     (d) Providing HIV testing unless the pregnant woman refuses to give consent;

     (e) If the pregnant woman refuses a confidential test, discussing and addressing reasons for refusal and document in the medical record that refusal and the provision of education on the benefits of HIV testing;

     (f) If the risk screening indicates, providing or referring for behavioral change counseling for women who:

     (i) Have or recently have had a sexual partner(s) who is known to be HIV infected or is a man who has sex with another man or is an injection drug user;

     (ii) Uses or recently have used injection drugs;

     (iii) Have signs or symptoms of HIV seroconversion;

     (iv) Currently have or recently have exchanged sex for drugs or money or had a sexually transmitted disease or had multiple sex partners; or

     (v) Express a need for further, more intensive counseling; and

     (g) Basing the behavioral change counseling on the standards defined in WAC 246-100-209 and the recommendations of the federal Centers for Disease Control and Prevention published in Revised Guidelines for HIV Counseling, Testing and Referral, and Revised Recommendations for HIV Screening of Pregnant Women, November 9, 2001; and

     (h) Offering referrals and providing follow-up to other necessary medical, social and HIV prevention services.

     (2) Health care providers may obtain a sample brochure addressing the elements of subsection (1)(b) of this section by contacting the department of health's HIV prevention program at P.O. Box 47840, Olympia, WA 98504-7840.

     (3) Principal health care providers shall counsel or ensure AIDS counseling as defined in WAC 246-100-011(2) and offer and encourage HIV testing for each patient seeking treatment of a sexually transmitted disease.

     (4) Drug treatment programs under chapter 70.96A RCW shall provide or ensure provision of AIDS counseling as defined in WAC 246-100-011(2) for each person in a drug treatment program.

     (5) Health care providers, persons, and organizations providing AIDS counseling in subsections (3) and (4) of this section shall:

     (a) Assess the behaviors of each individual counseled for risk of acquiring and transmitting human immunodeficiency virus (HIV);

     (b) Maintain a nonjudgmental environment during counseling which:

     (i) Considers the individual's particular circumstances; and

     (ii) Is culturally, linguistically, and developmentally appropriate to the individual being counseled.

     (c) Focus counseling on behaviors increasing the risk of HIV acquisition and transmission;

     (d) Offer or refer for HIV testing and provide or ensure provision of personalized risk reduction education to individuals who are determined to be at increased risk for HIV as defined by Federal Centers for Disease Control and Prevention published in Revised Guidelines for HIV Counseling, Testing and Referral, November 9, 2001.

     (6) Persons and organizations providing AIDS counseling may provide additional or more comprehensive counseling than required in this section.



[Statutory Authority: RCW 70.24.130 and 70.24.380. 05-11-110, § 246-100-208, filed 5/18/05, effective 6/18/05. Statutory Authority: RCW 70.24.380. 02-12-106, § 246-100-208, filed 6/5/02, effective 7/6/02. Statutory Authority: RCW 70.24.125 and 70.24.130. 99-17-077, § 246-100-208, filed 8/13/99, effective 9/1/99. Statutory Authority: RCW 43.20.050 and 70.24.130. 92-02-019 (Order 225B), § 246-100-208, filed 12/23/91, effective 1/23/92. Statutory Authority: RCW 43.20.050. 91-02-051 (Order 124B), recodified as § 246-100-208, filed 12/27/90, effective 1/31/91. Statutory Authority: Chapter 70.24 RCW. 88-17-058 (Order 318), § 248-100-208, filed 8/17/88.]