As a general rule, your medical record, including your HIV status, is confidential. In most states, your physician must protect your confidentiality; physicians can disclose information about patients only under certain conditions. In fact, no one with access to your HIV status—laboratory staff, hospital staff, nurses, secretaries—is allowed to reveal your name. Your name can be revealed only if you sign an authorization. Revealing your name without signed authorization is grounds for suit. If your name has been revealed, you can bring a civil law suit against the person who revealed it. If the person was a physician, the state board that licenses physicians and the physician’s professional society can review the incident. As with any law, your right to the confidentiality of your medical records has conditions. When you apply for insurance, you usually authorize the company to request release of your medical records. Your HIV status must be included in those records: medical records are, by definition, complete medical records. If you check into a hospital, you implicitly authorize access to your medical records to all your health care providers at that hospital, including other physicians, nurses, dentists, and physician’s assistants. If your physician refers you to a specialist and you accept the referral, you implicitly grant the specialist access to your medical records. If you apply for a job, depending on the state, your prospective employer might be able to request your medical records, but your records will be released only if you authorize it. Prospective employers may not require you to authorize release. Physicians must report every case of AIDS they treat to the state public health department. Some states require physicians to report ARC and all blood tests positive for HIV infection. Most states require that this reporting be done either by name or by such other identifiers as social security number. The state public health departments are prohibited from revealing your name. In the unlikely event that your name is revealed, most states give you some sort of legal recourse—to a lawsuit, for instance. States are required to report cases of AIDS to the federal government, but to report the cases as statistics, not by name. HIV infection also confers certain obligations on you. You have a moral and legal obligation to notify anyone you have put at risk. In general, this includes sex partners and drug users with whom you have shared needles. Health care workers might be obliged to inform the institutions in which they work. If you refuse to notify those you have put at risk, or continue to place others at risk without due warning, they can sue you. If you refuse to inform anyone you put at risk for infection, your physician may be under obligation to inform him or her. The American Medical Association has advised physicians of that obligation. In some states, the physician’s obligation to inform is law; other states have legislation pending that will make this a law. Thus, whether your physician is required to reveal your name and diagnosis without your authorization depends on the circumstances and varies from state to state. Once the obligation to inform those placed at risk is discharged, however, you have no further legal or moral obligation to tell anyone else about your HIV status. You have no obligation to tell your employer, your landlord, your psychologist or psychiatrist, your family, your friends, your co-workers, or your neighbors. Lawyers often advise their clients who have HIV infection to tell as few people as possible. Except for those whom you are obliged to tell, tell only the people you love and who will help you and respect your privacy. No one else needs to know.*200\191\2*
9 July 2011
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