NRPM: Standards for Privacy of Individually Identifiable Health Information. HIV/AIDS

11/03/1999

Early detection is essential for the health and survival of an HIV (Human Immunodeficiency Virus) positive person. Concerns about the confidentiality of HIV status may prevent some people from getting tested. For this reason, each state has passed some sort of legislation regarding the confidentiality of HIV status. However, HIV status can be revealed indirectly through disclosure of HAART (Highly Active Anti- Retroviral Therapy) or similar HIV treatment drug use. In addition, since HIV/AIDS (Acquired Immune Deficiency Syndrome) is often the only specially protected condition, “blacked out” information on medical charts could indicate HIV positive status. 29 Strengthening privacy protections beyond this disease could increase confidence in privacy regarding HIV as well. Drug therapy for HIV positive persons has proven to be a life- extending, cost-effective tool. 30 A 1998 study showed that beginning treatment with HAART in the early asymptomatic stage is more cost-effective than beginning it late. After five years, only 15 percent of patients with early treatment are estimated to develop an ADE (AIDS-defining event), whereas 29 percent would if treatment began later. Early treatment with HAART prolongs survival (adjusted for quality of life) by 6.2 percent. The overall cost-effectiveness of early HAART treatment is estimated at $23,700 per quality- adjusted year of life saved. 31