Contractual health-care workers who treat prison inmates may be required to undergo testing for the AIDS virus if the procedures they perform create a "significant risk" for transmitting the virus.
The testing may be required if the health-care providers "regularlyengage in medical procedures that could expose patients to their blood and if the medical evidence shows that patients are subject to a 'significant risk,' " Attorney General J. Joseph Curran Jr. wrote in an opinion to Gov. William Donald Schaefer that was made public today.
In his opinion, Curran told Schaefer that federal law prohibit
ing discrimination against disabled people -- including those with the human immunodeficiency virus, which causes acquired immune deficiency syndrome -- "does not preclude special restrictions on . . . HIV-positive health-care providers if the restrictions are justified on medical grounds."
According to the opinion, studies of HIV transmission indicate that no special precautions are required for HIV-infected workers who come into only casual contact with patients.
But there is a "risk of transmission of HIV infection from a health care worker to a patient . . . in situations where there is trauma to the patient, as in invasive surgical or dental procedures, and trauma to the worker, such as a scalpel or needlestick injury," the opinion stated.
The opinion said that the federal Centers for Disease Control and the Governor's Advisory Council on AIDS urge health care providers "to adhere to 'universal precautions' when engaging in invasive procedures," particularly by wearing latex gloves.
"The barriers of gloves protect both the patient and the provider," the opinion said.
The percentage of AIDS-infected prisoners in Maryland is estimated to be 8 percent, the opinion said. There are about 18,000 inmates in state prisons.
Curran advised Schaefer after the governor requested him to investigate the testing following the AIDS-related deaths of two dentists who treated more than 1,900 inmates at the Maryland Penitentiary.
Schaefer said last month that he would support testing of all state government health-care providers.
The opinion, specifically addressing contractual health-care workers in the state correctional system, paves the way for the governor to initiate a much more limited policy. However, he would likely solicit additional counsel from medical experts before "dropping the other shoe in this nationally significant is
sue of mandatory testing," one high-ranking member of Schaefer's staff said today.
In an interview, Curran said the opinion does not address the broader groups of correctional officers and other state medical workers.
"We are not answering any larger questions, only the very narrow point of workers under contract providing medical or dental care to state prison inmates," Curran said. "We are not looking at psychiatrists, ear doctors, professionals who do not engage in intrusive types of care."
Assistant Attorney General Jack Schwartz, who researched the opinion for Curran, said today that Maryland "seems to have been the first state to have gone forward" on the testing issue.
Dr. Victor Luckritz, 47, who died May 7 of AIDS, worked as chief dentist for the Maryland Penitentiary between June 1988 and April 1990.
Maryland prison officials have offered counseling and HIV testing to 1,893 inmates treated by Luckritz and 53 treated by Dr. H. Dale Scott, who died of AIDS Oct. 12, 1990. Scott substituted in May and June 1989 for Luckritz.