implications of both forms of the patients diseases, HIV and AIDS, from the perspective of HIPAA confidentiality.

Include the following in your essay:** - Discuss why HIV and AIDS information is more sensitive than other types of health conditions.**** - Examine the social, legal, and ethical ramifications of improper information disclosure.**** three references from the University Library or the Internet

Implications of HIV and AIDS HIV/AIDS

A person infected with HIV (Human Immunodeficiency Virus) has a immune system which is more vulnerable to the life-threatening diseases and infections that normally would not even affect healthy people. The immune system is attacked by HIV on its CD4 cells. AIDS (Acquired Immune Deficiency Syndrome) is the stage of HIV, and it is not necessary that people with HIV also have AIDS.

What are the Symptoms?

There are no clear symptoms, but the people affected with HIV/AIDS are more vulnerable to Opportunistic Infections (Ols). These infections affect different parts of the body.

Causes

HIV infects essential organs of humans affecting the immune system. It destroys CD4+ T cells. A medical consequence of infection with HIV is AIDS. HIV progresses in time to HIV infection and then later to, AIDS. This development from HIV to AIDS is caused by various factors such as the ability of a persons body to defense itself against HIV, poor health or existence of other diseases, genetic inheritance can also push HIV faster towards AIDS. HIV is in high concentration in various body fluids such as breast milk, seamen, blood and the vaginal flora. These body fluids infect other person when entered through open wounds and various mucous membranes. Here are some of the ways that HIV/AIDS spread from person to person.
Sexual transmission

The risk of HIV is greater in the sexual encounters or transmissions, especially for the people on the receptive side that is why women are usually more susceptible to HIV-1 infection due to high risk of transmission of sexual diseases. The risks are even higher for people who have multiple sex partners

who in turn affect their partners and spread the disease further by having unprotected sex with other people. In terms of age and the susceptibility rate, girls are 2-4 times at greater risk than men.
Blood Products

The risk of transmission of HIV through the use of blood products is high. It includes drug users who use and share contaminated needles to inject drug into their systems, use of syringes which are HIV-infected and the people who receive tattoos and piercings. The use of contaminated syringes is said to be the cause of one-third of infections in North America, China and Eastern Europe. Around 2.5% of HIV infections in Sub-Saharan Africa are caused by unsafe injections.
Perinatal Transmission

Hepatitis B virus (HBV) infection in a pregnant woman is a serious risk to her infant at birth. It is said that 40% of infants born to mother who are HBVinfected in US will develop chronic HBV infection, of which 25% will die from chronic liver disease.

Effect of HIV/AIDS

Around 33.3 million people worldwide are living with HIV/AIDS with 2.6 million HIV infections per year and 1.8 million deaths due to AIDS annually, as of

2009. Around 33.2 million people worldwide had AIDS in 2007, in which 2.1 million were killed the same year, which included around 330,000 children and more than three quarter of the deaths occurred in Sub-Saharan Africa. In Southern Africa, 60 million people were infected including 25 million deaths and 14 million children who became orphans since this disease has begun.

http://www.prb.org/pdf06/HowHIVAIDSAffectsPopulations.pdf

HIV/AIDS does not affect anyone on the basis of gender, race, age, sexual orientation or status but nonetheless, certain groups are highly susceptible to HIV/AIDS risk like men sex with men (MSM), drug user injectors and Commercial Sex Workers (CSWs). The mortality rates and life expectancy rates have also dropped. AIDS is a devastating disease which killed 3.1 million adults and children in 2005, in which 2.4 million were sub-Saharan Africa.

There has been a huge increase in India and China in HIV infections recently. India has the largest number of people whore infected WITH hiv AND MOST OF THEM are young. Only less than 1 percent of adults are infected. Other countries like Vietnam, Indonesia and Pakistan could be on the verge of serious epidemics. Main drivers of the increase in these diseases are commercial sex and injecting drug-usage. The main problem is the spread od HIV from population which practices high risky behavior to the general population.

http://www.prb.org/pdf06/HowHIVAIDSAffectsPopulations.pdf

Mortality and Life Expectancy

People who have HIV/AIDS develop other illnesses and infections very quickly because of their weak immune systems therefore there have been an increase in the pneumonia and tuberculosis in many regions also Life expectancy rates are also affected. The children under 5 years in SubSaharan Africa has high mortality rate. One third of the children born with HIV die before their first birthday and 60 percent die before theyre 5 years old.

Age & Sex Structure

The alteration of age structure is also occurring. The developing countries with High HIV/AIDS have this disease affecting adults in their prime working ages. Women are more receptive to HIV/AIDS epidemic therefore their deaths affect the families in a big way. It is the most critical issue of reproductive health in this era. Young women nowadays are more vulnerable to STDs. Poverty, dependency of women on men tends to make them further vulnerable to unprotected sex. Also, the women who are of childbearing age have risk of infecting their children.

Households

HIV/AIDS affect households a lot. Persons ability to support, work and provide for his/her family diminishes. The health care costs, treatment, etc reduces the overall income of the family

If parents die, the families break and the children then have to live with their relatives or fend for themselves.

Healthcare Systems

Since the demand for HIV/AIDS healthcare is increasing because its spreading, the healthcare systems expenses have risen. Allocation of limited resources, health concerns, burden of costs borne by everyone involved, is increasing.

Business and Agriculture

Businesses are also affected by HIV/AIDS. Loss of workers, absenteeism, high health care costs (benefits) for AIDS drugs, then payment of death payments have increased. HIV/AIDS when affects farmers, the workforce declines.

www.uneca.org/chga/doc/SOCIO_ECO_IMPACT.pdf

Income

Expenses incurred in the early stages of the disease are treatment of headaches, diarrhea, and fungal infections and when the immune system becomes more compromised, income is invested into expensive antiretroviral (ARV) drugs and associated antiretroviral therapy (ART) or the affected family member succumbs to the complications of AIDS.

In cases where ARV is not used, other resources are used in palliative care to reduce the pain and suffering of an AIDS patient. To cover ART or other medical costs, assets might be sold, money borrowed from formal or informal sources, and/or other non-health related expenditures modified.

The disease and health expenses decrease, the reduction in household income from losing a household member can take time to normalize. Further, families might be left with debts to service, pushing households into a health-induced poverty trap. The income and expenditure implications of AIDS for average households in each quintile are modeled using household survey data, reports, and expert opinion where available.

HIPAA Confidentiality

Why is AIDS a sensitive issue? Health Insurance Portability and Accountability Act of 1996 is a law made to protect consumers privacy related to their health care data like their medical history, lifestyle and diagnosis. The law affects health care providers, health plans and health care clearinghouses. The confidentiality of the patients is kept under wraps. Their information cannot be given to the third parties like insurance companies, attorneys, employers and neighbors, even their financial information cannot be given to

anyone else. The healthcare providers cannot take the patients names, and the confidentiality is to be maintained at all times. But why is there a need for this confidentiality? Why is AIDS such a sensitive issue, even more than the other diseases? Every society has some barriers and the people living in that particular society are expected not to cross those barriers. Also, due to different myths, superstitions, social stigmas attached to HIV/AIDS like HIV can be transmitted through mosquito bites or shaking hands with the infected person and its attachment to sexuality makes it a very sensitive issue and its prevention becomes even more difficult in some countries where sex talks are not so common. When doctors gather patients health information, they do it so that they can properly give them diagnosis, and find cure for the diseases. But if they divulge their health information further: It can damage patients confidence in their physicians Patients become very cautious in giving out any information or they start keeping important information to themselves which is wrong because to keep a track of their illness, it is necessary that their physicians have full accurate information
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The breach of confidentiality can discourage patients from receiving the care they need

The information could be misused by someone else

HIPAA protects individuals. These regulations can be used broadly. It has four parts:
Portability

HIPAA helps individuals in getting health insurance if there is an existing medical condition
Transaction

It standardizes the process of how the information can be reported which includes claims, enrollment, eligibility and payment
Privacy & Security

Protect patients rights to keep their health information private. The protected health information (PHI) can be any type of information like name, address, medical records etc. The health care providers cannot disclose the information without the proper consent form patients. There are certain places where health information is not covered: De-identified health information Research done outside the covered information Studies done that do not involve health information

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The social, legal, and ethical ramifications of improper information disclosure

If in the case where the information is disclosed to other people, the consequences can be very high. Legally, law cannot remedy all breaches in the privacy like health disclosure by a family or a friend, cannot be fought against, but disclosure of information by an agency or an employee of government can result in constitutional privacy claim. Nowadays, people who HIV/AIDS have more rights and can take official action against anyone breaching their privacy or discriminating against them. The reporting of patients health information, their medical records, diagnosis etc, is a serious issue. How the reporting is done is a serious issue, because once the computerized information is disclosed, confidentiality is compromised and it might discourage patients from seeking help because of the fear of their information being misused by doctors, insurance companies and pharmacies. According to law,
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The penalty for Civil is $100 per violation, up to $25,000 per person, per year for each requirement or prohibition violated.

Criminal penalties are up to $50,000 and one year in prison for obtaining or disclosing protected health information under false pretenses; and

up to $250,000 and up to 10 years in prison for obtaining or disclosing protected health information with the intent to sell, transfer or use it illegally

Socially, people are bound by their cultural beliefs and traditions, fears any other inhibitions because of which they prevent themselves from acting on the knowledge they have. Even when the patients learn that they are HIV positive, they do not tell anyone or even go to the doctors from the fear of everyone knowing about this disease. Also, people in the society do not like to talk about sexual matters because,
i. they might not want to acknowledge the fact that their young children are

sexually active
ii. They might believe that HIV/AIDS prevention programs might encourage

young teenagers to become sexually active Other concerns include job loss, embarrassment in the workplace and among peers and friends like. HIPAA Confidentiality saves employees from discrimination claims whenever employers used information improperly. Now the privacy regulations will allow employers limited access to health information (i.e. for purposes of paying health insurance only).97 The potential for abuse of health information still exists, but the new privacy protections coupled with the ADA will give injured persons with HIV/AIDS

http://www.ifla.org/files/faife/publications/learnmat/ifla-hiv-aidsworkshop-manual.pdf http://www.prb.org/pdf06/HowHIVAIDSAffectsPopulations.pdf

UNAIDS, 2006 Report on the Global AIDS Epidemic (Geneva: UNAIDS, 2006)

The Global Challenge of HIV and AIDS, Population Bulletin 61, no.1 (2006): 8-9