Spreading the Word

Although breaches of HIV confidentiality laws are not as frequent or heinous as they were in the earliest days of the epidemic, such incidents still occur, according to American Civil Liberties Union attorneys who worked on a November 2003 report documenting AIDS-related discrimination around the country. Two common environments for such privacy breaches'and other forms of HIV-related discrimination'are health care facilities and the workplace, particularly the food service industry. 'A lot of people in all kinds of food-handling or food service businesses face discrimination because of the ignorance of how HIV is transmitted and of concerns and fears that someone working with food is going to give you HIV,' Leslie Cooper, a staff attorney with the ACLU's AIDS Project, says. Employers may disclose to other workers that an employee is HIV-positive, inappropriately seek access to a worker's medical files, or make public references to an employee's serostatus. It is also common for HIV-positive workers in any field to be demoted, fired, or denied employment once word gets out that they are infected, Cooper says. The inadvertent revealing of HIV-positive patients' medical information is a persistent problem in health care settings, according to the ACLU. Some common examples include doctors discussing a patient's medical information while friends or family members are present, receptionists or nurses at a clinic or physician's office referring to a patient's HIV case while within earshot of other patients, or even public discussion of the anti-HIV drugs a patient is taking. One case reported by the ACLU involved a New Mexico man who learned he was HIV-positive from a receptionist in front of a full waiting room. 'It surprised us'the breadth of problems we discovered,' says the ACLU's Tamara Lange of the HIV disclosures and discrimination reported in the November study. 'Breaches of confidentiality can and do unravel people's lives, forcing them to find new jobs, new schools, and new homes.'