HIV/AIDS: A Look At The Discrimination Issue
Writing in this week's New England Journal of Medicine, George Annas of the Boston University School of Public Health recaps the Supreme Court's majority and minority opinions in Bragdon v. Abbott, the case which "gave the Court the opportunity to interpret the [Americans with Disabilities Act] as it applies to HIV infection and to rule that Congress intended HIV infection to be included as a disability under the law." Annas addressed the "many questions" left unanswered by the court's decision that "reproduction is a major life activity under the ADA," and since having HIV impairs the ability to reproduce, it is a disability. He wrote: "The Supreme Court assumes that reproduction will be accomplished by sexual intercourse, and it is this act that puts the sexual partner at risk. Of course, with the new techniques of assisted reproduction, sexual intercourse is not required for reproduction. Moreover, with the use of donor gametes and a 'surrogate' mother, there is no risk of transmitting HIV to the child. The point is that what HIV infection really limits is the combination of sex and reproduction, not either one in isolation." He writes that the court's decision, however, "might mean that infertile persons who needed time off from work to undergo treatment for infertility could not be discriminated against for this reason." But the court did not "discuss the question of whether the patient would be protected by the ADA if she were infertile (e.g., because of a hysterectomy) before she became infected with HIV." He argues that "if the risk of HIV transmission from mother to child were reduced to zero or nearly zero because of improved prevention methods, HIV would then no longer substantially limit reproduction" (10/22).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.