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When the Supreme Court ruled June 25, 1998 that people with HIV qualify for legal protection under federal disabilities law, at least two classes of Americans were potential winners: those with the HIV infection and people who are infertile. The court decided 5-4 that a woman with HIV meets the criteria for a disabled person because she cannot safely have children - and therefore is protected from discrimination under the Americans with Disabilities Act (ADA). At issue is whether reproduction is a "major life activity."

SIDNEY ABBOTT SUED DENTIST RANDON BRAGDON in 1994 because he refused to work on her teeth in his dental office in Bangor, Maine. Abbott told Bragdon she had HIV, the virus that causes AIDS. The dentist insisted on fixing her cavities in a hospital, even though Abbott showed none of the symptoms of AIDS. Abbott sued, claiming Bragdon illegally discriminated against her as a disabled person. She argued that, under the 1990 ADA, she was disabled because the HIV infection prevented her from having children without exposing the fetus and her partner to the disease.

Protection under the ADA turns on whether an individual is "substantially limited" from engaging in a "major life activity." Writing for the majority, Justice Anthony Kennedy said "we have little difficulty concluding that it is." The decision also said that impairment begins at the moment of infection, not just when symptoms develop. "HIV infection satisfies the statutory and regulatory definition of a physical impairment during every stage of the disease," Kennedy wrote. The majority opinion was joined by Justices John Paul Stevens, David Souter, Stephen Breyer, and Ruth Bader Ginsburg.

Chief Justice William Rehnquist dissented, saying that reproductive decisions are important to a person's life, but that reproduction does not constitute a major life activity under the ADA. "The common thread is rather that the activities are repetitively performed and essential in the day-to-day existence of a normally functioning individual. They are thus quite different from the series of activities leading to the birth of a child," Rhenquist wrote. He was joined in the dissent by Justices Antonin Scalia, Sandra Day O'Connor, and Clarence Thomas.

While a substantial victory for people with the HIV infection, the decision was a mixed finding for Sidney Abbott. The Supreme Court ordered the First US Circuit Court of Appeals to revisit the question of how much risk the dentist faced in treating Abbott in his office.