The Americans With Disabilities Act (ADA) was widely hailed at the time of
its enactment in 1990 as providing broad protection against disability disc
rimination, including discrimination against individuals infected with the
human immunodeficiency virus (HIV), In the years since its enactment, howev
er, courts frequently interpreted the ADA as providing far less protection
than was initially anticipated. The Supreme Court's first case involving HI
V and the acquired immunodeficiency syndrome, Bragdon v Abbott, addressed t
his trend by ruling that a woman with asymptomatic HIV infection is protect
ed from discrimination in accessing dental services. In doing so, the Court
endorsed an interpretation of the ADA that is broadly protective for indiv
iduals with disabilities. The Court also ruled that health care professiona
ls may legally refuse to treat a patient because of concern that the patien
t poses a direct threat to safety only if there is an objective, scientific
basis for concluding that the threat to safety is significant. In addition
to the ADA, state laws frequently prohibit disability discrimination and a
pply to some employers and others not regulated by federal law. A state-by-
state survey of those laws demonstrates that, consistent with Bragdon v Abb
ott, individuals with asymptomatic HIV have widespread protection on the st
ate level.