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Implications of HIV and AIDS from the Perspective of HIPAA Confidentiality Your Name AXIA College of University of Phoenix
HIV and AIDS are the most serious diseases to date. Doctors discovered the first case of AIDS in the U.S. around 20 years ago, and today an estimated 42 million people live with HIV and AIDS (Teens Health, 2009). Additionally, another 300,000 people are estimated to have either HIV or AIDS but are unaware of their condition. Around 40,000 new HIV infections occur annually (The Body, 2001). As long as HIPAA exists, the privacy of every patient’s medical information—including any information about HIV and AIDS—will be protected and information will remain confidential (The Law Office of Kendra S. Kleber & Associates PLLC, n.d.). AIDS is caused by the human immunodeficiency virus (HIV). The body’s CD4 helper lymphocytes, which are defense cells, are destroyed by HIV. These lymphocytes are contained in the immune system, which is the bodily system that helps to ward off infections. As the CD4 lymphocytes are being destroyed by HIV, the body begins to develop other infections that would normally not affect it. Once the immune system has been destroyed by HIV, the body develops acquired immunodeficiency syndrome (AIDS). People who have AIDS are unable to fight off infections. HIV can be transmitted in several ways, such as through shared needles, semen from an individual that is infection, blood, breast milk, and to a baby during childbirth from an infected mother (Teens Health, 2009). Understanding what exactly the Health Insurance Portability and Accountability Act (HIPPA) is will help in an understanding of the implications of HIV and AIDS from the perspective of HIPAA confidentiality. HIPAA was enacted by Congress in 1996 as a way to prevent patients’ health information from being inappropriately used. Restrictions by HIPAA have been placed on how medical records are handled and who is able to access the information. HIPAA has four parts. The first is transaction, which is the process that takes place when health-
related information is reported. The second and third are security and privacy of protected health information. The fourth is portability, which is concerned with preserving an individual’s ability to have health insurance whether they have a preexisting or current medical condition. HIPAA has put regulations and rules into action for ensuring that rights are preserved and confidentiality is protected for every individual; this includes people with HIV and AIDS. HIPAA’s regulations and laws have limited the use of preexisting conditions. Because of HIPAA, health plans cannot discriminate against anyone with a denial of coverage due to a family member’s poor health. Specific individuals and small employers that lose job-related health insurance coverage are guaranteed the right purchase individual health insurance, thanks to HIPAA. No matter an individual’s health condition(s), if that person has bought health insurance, he or she is able to renew that policy under HIPAA (Biel-Cunningham, 2003). Information about HIV and AIDS is kept confidential. When referring to the HIPAA regulations, private and confidential are two different concepts. Confidential information is any information that could be damaging and highly sensitive, which is why special laws are in place to protect any confidential information. Information that is private is information that an individual wishes for no one else to know about. This type of information is not always protected and its status can change according to the situation. An individual may be HIV-negative, HIVpositive, or HIV-untested, and that person’s information enjoys protection under the HIV confidentiality law. Patients’ information is protected by HIPAA wherever they go. For example, if a hospital employee learns any information of a medical nature at work, and then shares that information with a friend, the employer is responsible. Treating sensitive information so carefully is important in cases of HIV and AIDS. Some people may wish to treat a patient’s HIV status as just another bit of information, but in reality all information about HIV and AIDS is
very different from other types of information, and thus it needs to remain confidential. Any HIV information is medical information, and therefore it must always be confidential, no matter who the information relates to (The Law Office of Kleber & Associates PLLC, n.d.). Information about HIV and AIDS is so sensitive because of potential stigmas attached to having either condition. One such stigma is how the person caught the disease—someone may assume that a patient caught it from sharing needles or from a sexual partner, but may actually have received the infection from her or his mother during labor and delivery. The myths that only drug users and gay men contract the HIV virus leads to this stigma. The majority of people worry about discrimination as a result if their HIV-positive status is known. Of course, anyone is at risk for HIV or AIDS, especially if they engage in higher-risk behaviors. The confidentiality of HIV and AIDS information is now very strict due to HIPAA. People who have either condition are protected from discrimination by HIPAA regulations. In addition, there are ethical, legal, and social ramifications when HIV or AIDS status is improperly disclosed. Because of the Americans with Disabilities Act of 1990 (ADA), employers are not allowed to discriminate against potential or current employees due to disability status. HIV and AIDS are included in the category of “disability status.” Employers should always keep four key points in mind: understanding the responsibilities and duties of the job; the definition of disability; what reasonable accommodation is; and keeping medical information confidential and limiting its release within legal boundaries. If a disable person can perform a job’s functions, he or she is qualified for that job. As drug therapies become more effective and new ones are discovered, length of life and quality of life for HIV-infected people are improving, which means that they return to work as their health improves or is stable. Lawsuits are continually being filed by employees against their employers for improper information disclosures and discrimination.
HIV-positive workers can file lawsuits under the ADA. However, most lawsuits can be avoided through proper training and education. Social ramifications also exist if HIV and AIDS information is released improperly. If a person’s friends and acquaintances learn that he or she has HIV or AIDS, they may not want to be around that person anymore out of (a usually unfound) fear of catching the disease themselves. HIV and AIDS status can also become a piece of gossip, shared and spread and damaging the life of the affected person. That person will be looked at differently and treated differently. He or she may also have a harder time finding employment if employers find out about his or her status due to the improper release of medical information. HIV and AIDS not only hurt people and their families and friends. It also damages societies and economies worldwide. Once HIV started spreading among young adults, it had long-term economic implications that were related to lost productivity. The International Labor Organization believes that by the year 2020, HIV and AIDS will have lowered the workforce by 24 million people. Workforce costs will increase because of higher payments for medical care and insurance, as well as work absences related to health, hiring, and costs of retraining. National incomes and growth will significantly decrease as the number of people who have HIV and AIDS increases (The Body, 2001). Because of the stigmas and reputations associated with HIV and AIDS, it is essential to maintain a person’s status confidential. So much harm can come when a person’s medical information is handled incorrectly—it can result in hardship and personal pain. Anyone who learns of a patient’s, client’s, or customer’s HIV status must keep that information confidential. If that status is related to the work he or she does, the status must be kept protected and private at
any cost. If the status of a customer, friend or client is not relevant to what the person does, his or her status should not be questioned. The goal of confidentiality laws is met when people who have HIV or AIDS can control his or her own medical condition. No reason exists to discuss an individual’s HIV status without that individual’s permission, under the confidentiality laws (The Law Offices of Kleber and Associates PLLC, n.d.). HIPAA has enforced many regulations and rules that carried civil and criminal penalties —this has been done to ensure that the rights and confidentiality of individuals are safeguarded. Any person who is part of the care of a person infected with HIV is aware that she or he has to keep that person’s confidentiality. All individuals receive protection thanks to the general guidelines about the release of health information, including HIV and AIDS status, although HIPAA does not address this information separately. This information can be misused and result in harm to the health and well-being of patients. They can suffer discrimination in healthcare, employment, and insurance. Therefore, each person who is part of the care of an individual with HIV or AIDS has to keep that status confidential lest legal, ethical, and social ramifications arise (The Body, 2001).
References Biel-Cunningham, S. (2003). Understanding Your Rights Of Insurance Portability. Retrieved
July 28, 2009, from http://www.thebody.com/content/art32201.html Law offices of Kendra S. Kleber and Associates PLLC. (n.d.). HIV Confidentiality. Retrieved July 28, 2009, from http://www.positiveoutlook.org/PAGES/101.htm Teens Health (2009). HIV and AIDS. Retrieved July 28, 2009, from http://kidshealth.org/teen/sexual_health/stds/std_hiv.html The Body (2001). Why We Should Care: HIV in the United States. Retrieved July 28, 2009, from http://www.thebody.com/content/art33064.html
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