HIV Discrimination in Health Care Services in Los Angeles County

Introduction

This report presents the results of three studies conducted from 2003 to 2005 measuring HIV discrimination in health care in Los Angeles County. Each of the studies used trained testers posing as either patients who were HIV-positive or organizations working with such patients. Testers called the offices of health care providers and asked if they would accept HIV-positive patients. The studies focused on skilled nursing facilities, cosmetic and plastic surgeons, and obstetricians, in order to determine the percentage of providers in each area who had a blanket policy of refusing services to people living with HIV. The testers also gathered some qualitative information about the reasons why health care providers denied services to HIV-positive patients. The three types of health care providers were chosen based on the current medical needs of persons living with HIV/AIDS, including nursing care as the HIV population ages, cosmetic surgery to address the impact of facial wasting, and prenatal care for women living with HIV.

The three testing studies discovered that HIV discrimination remains quite common in the health care sector despite legal prohibitions. The studies found that 46% of skilled nursing facilities, 26% of plastic and cosmetic surgeons, and 55% of obstetricians in Los Angeles County would not take any patient who was HIV-positive for any type of service, even when patients were asymptomatic.

The most common reasons for denying services to HIV-positive patients included lack of expertise or equipment by the health care provider, never having treated an HIV-positive patient before, staff that were inadequately trained or who would refuse to treat HIV-positive patients, and the blanket referral of all HIV-positive patients to “specialists.”

The studies demonstrate that laws protecting persons living with HIV from discrimination in health care need to be strengthened and that further education and training of healthcare workers about such laws is necessary.

Download the full report