AIDS: issues involving disclosure, privacy, discrimination, insurance coverage

What is AIDS?
As most people know, AIDS stands for Acquired Immune Deficiency Syndrome. It is a disease transmitted through body fluids, and is classified as an STD. Discovered in 1981 in France, AIDS has spread very quickly through the world and now involves many issues, including those of societal stigma, legislative problems, and many more.


In this WIKI:
Sociology
AIDS virus attacking a cell
AIDS virus attacking a cell

  • Disclosure
  • Prvacy
  • Discrimination
  • Insurance Coverage
Legislation
  • Disclosure
  • Privacy
  • Discrimination
  • Insurance Coverage


Science
  • How AIDS infects
  • General Information
  • The science behind AIDS
Educator
  • 'Thought-provoking' questions
The Sociologist says....
AIDS in general is looked down upon in society because of its connotations with intravenous drugs and the fact that it can only be transmitted through bodily fluids. It is for this reason that many people affiliated with the disease are reluctant to disclose their conditions to the general public. In this case, ignorance is not bliss. In a study conducted by CAB Abstracts and published by Medknow Productions, in which researchers tested 800 people's knowledge of HIV/AIDS through a questionnaire with 65 items regarding all aspects of HIV/AIDS- general knowledge, knowledge of transmission, general attitude, and evaluation of governmental measures taken to hinder the epidemic. The results were as follows:
-80.63% were "sketchily aware" of AIDS, but had many misconceptions of transmission or prevention
The general consensus in terms of conclusion was that discrimination is widespread, but mainly only because of the lack of knowledge out there about it.

Disclosure
Most people with AIDS do not disclose that they have it because of the social stigma surrounding the issue. This causes less people to know, and more people to be at risk of being infected with AIDS because they do not practice enough caution. Others, however, do tell people that are close to them because they feel the need to be honest and protect their friends and family. Unfortunately, though, there are more people who have the mentality of the former type than those that have the mentality of the latter.

Privacy
Privacy is a highly debated issue, especially in regards to AIDS. Some believe that those afflicted with AIDS should not have privacy, for the sole reason that, if kept secret, their ailment could potentially cause others in the community risk of infection. Others, however, believe that the option of privacy or no privacy should be given to the afflicted person or persons, in order to protect their identity as well as dignity. Most people who have AIDS agree with having the option of privacy, while on the other hand, people who don't suffer from this disease believe that communities have the right to be aware of such disease and its occurrence.
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Discrimination
There are many stigmas associated with AIDS that lead to certain discrimination against the victim. Stigmas are caused by factors in the psyches of many people such as:

  • Fear of contraction
  • AIDS' life-threatening nature
  • Stereotyped methods of contraction
  • AIDS is sometimes seen as a "punishment" for immoral behavior

Many people who discriminate fail to acknowledge the fact that AIDS is also transmitted through breastmilk, among other things.


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Insurance Coverage

Many people are denied insurance because of HIV/AIDS. Nevertheless, for many people living with AIDS, insurance has become critical to reserving their access to health care. When insurance fails to cover AIDS care, a last resort for many patients is Medicaid, the Goverment insurance program for the poor. Many AIDS infected people impoverish themselves to qualify and this includes quitting jobs and using up their saved money. Ultimately many confronting AIDS face extreme difficulty aquiring and maintaining insurance and health care. Also, on the more sociological side, people with AIDS are the prime targets for illegal insurance activity because of their need for insurance. Insurance companies depend on the fact that AIDS patients NEED their services, and are therefore willing to accept shortcomings. This however, is illegal [SEE BELOW]


The Lawyer says... external image laws.jpg
Here are some general rights of AIDS patients and their affiliated laws:

RIGHTS
LAWS
Right to fair labour practices
The Constitution The Labour Relations Act (LRA)
Right not to be unfairly dismissed because you have HIV
The Labour Relations Act (LRA)
Right not to be unfairly discriminated against on the basis of your HIV status
Employment Equity Act (EEA)
Right not to be tested for HIV unless your employer has applied to the Labour Court for authorisation
Employment Equity Act (EEA)
Right to a safe working environment
Occupational Health & Safety Act, and Mine Health & Safety Act
Right to compensation if infected with HIV at work
Compensation for Occupational Injuries and Diseases Act (COIDA)
Right to certain basic standards of employment, including 6 weeks of paid sick leave over a 3-year period
Basic Conditions of Employment Act (BCEA)
Right to no unfair discrimination in giving employee benefits
Medical Schemes Act
Right to privacy about your HIV status at work
Common law right


Disclosure
Laws about AIDS disclosure are often trumped by sociology relation to this issue, but as neglected as they are, they do in fact exist. At the point of sexual relations, AIDS disclosure is no longer a personal matter- in fact, it is in the hands of lawyers and judges. Law suits have been made against sexual partners who fail to disclose their infection to their significant other. Oddly, most law suits have been made against female prostitutes.
Laws differ, however, they are essentially the same. Take into consideration, California’s “Willful Exposure” Law. In order to be prosecuted, there are many terms and conditions:
  • Have anal or vaginal sex. You cannot be prosecuted for oral sex. As to anal and vaginal sex, the law applies equally to men and women; tops and bottoms. The law punishes exposing someone to HIV through these types of sex. Your sexual partner does not have to actually become infected.
  • Know that you are HIV-positive. You cannot be prosecuted for sex that you had before you knew that you were HIV-positive.
    Fail to disclose your HIV status. If you disclose before insertion, you cannot be prosecuted.
  • Fail to use a condom. Even if you do not disclose, you cannot be prosecuted unless you have "unprotected sex." The law defines "unprotected sex" as failing to use a condom. Even the woman has a legal obligation to make sure that your partner wears a condom.
  • Have the "specific intent" to infect the other person. Most likely, this element will prevent the statute from being used to harass people living with HIV. To be prosecuted, you have to engage in the sexual activity with the specific intention of infecting the other person with HIV. Just knowing that you had HIV when you had sex will not be enough. The law explicitly states that: "Evidence that the person had knowledge of his or her HIV-positive status, without additional evidence, shall not be sufficient to prove specific intent." Because of this specific-intent requirement, the law is narrowed in scope to only cover individuals who want to infect other people, and who are probably expressing that desire. If you slip up one time, it's unlikely that you will be prosecuted. However, the best way to stay clear of this law, and other legal liabilities, is to always disclose your status and/or practice safer sex.
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Privacy
Privacy laws are very sparse. They simply state that at the point of sexual relations, it is a liability to not tell your partner. However, the choice of whether or not to tell people lies solely with the afflicted person(s). No one else has the power to tell another person about the victim’s condition, even doctors, without their consent. This becomes a case liability.

Discrimination

Persons with HIV infection have been denied access to social services, or denied medical treatment, or had treatment or services delayed, solely because they have HIV or AIDS. Such actions by an agency, organization, hospital, nursing home, drug treatment center, clinic, medical or dental office, or other entity, may be unlawful discrimination under either Section 504 or the ADA, or both.
Examples of practices which are illegal discrimination could be:

  • A nursing home that has space available denies admission to a person with HIV, because their staff is not trained to care for HIV-related conditions, even though the home could easily provide the necessary training.
  • A social services agency removes a foster child from his foster home because the agency learns that one of the foster parents is a person with HIV.
Legal Protections Against Discrimination (as stated in Section 504 of the Rehabilitation Act of 1973 and the Americans with Disabilities Act of 1990 ("ADA"))
  • Both Section 504 and the ADA prohibit discrimination against qualified persons with HIV and other disabilities. Section 504 prohibits discrimination by health care and human service providers (called "entities") that receive Federal funds or some other types of Federal assistance.
  • Title II of the ADA prohibits discrimination by state and local government entities even if they do not receive Federal financial assistance. Examples of entities that may be covered by Section 504 and the ADA include hospitals, clinics, social services agencies, drug treatment centers and nursing homes.
  • Discrimination may occur if the entity excludes a person with HIV from participating in a service, or denies them a benefit.
  • The person living with HIV must meet the essential eligibility requirements for the benefit or service he or she is seeking.
  • The entity may be required to make a reasonable accommodation to enable the person with HIV to participate.
  • The ADA also protects other persons, such as family and friends, who are discriminated against because of their association with someone who has HIV.
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Insurance Coverage
Many AIDS patients suffer from malpractice of Insurance companies. Such malpractices include:
"Underwriting"
"Claim Problems"
"Large Premium Increases"
"Cancellations"
"Reductions in Coverage"


Science Behind AIDS
AIDS is a life-long, often fatal disease caused by HIV (human immunodificiency virus). The original infecting virus is HIV, but the later stages are referred to as AIDS. AIDS affects immune system cells, making them less able to fight disease-causing viruses, bacteria, and fungi. AIDS is now referred to as a "global epidemic," and about 38.6 million people are living with the disease; half are girls between 15 and 24. Since the epidemic began, 25 million people have died because of it.
INFECTION- HIV/AIDS infects lymph nodes, destroying helper T cells (a form of lymphocytes), which activate, direct, and maximize the effectiveness of other immune system cells. By destroying these, HIV/AIDS makes the immune system much more susceptible to other diseases, like pneumonia or meningitis. Also, the "victim" is more susceptible to certain types of cancers. The AIDS itself does not kill the patient- the infections that arise and that the body was not able to fight because of the AIDS is what actually ends up killing them.

In 1993, the Center for Disease Control (CDC) stated that "AIDS" itself was the stage at which AIDS antibodies were present in the body as well as one of the following:
-Development of an infection that occurs when the immune system is weak ("opportunistic infection")
-A helper T cell count of less than 200 (The average count is between 600 and 1,000).
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Educator

  • Should insurance companies be allowed to test for HIV/AIDS in their underwriting process legally?
  • Should privacy laws be stricter? Why? Why not? How would they be enforced?
  • Should AIDS sufferers be required to inform the people they work with/the people around them that they have AIDS? Why or why not? How would this be enforced?
  • Is it ethical to have AIDS and keep it a secret?
  • Should it be illegal to not tell your sexual partner even if you abide by the laws?
  • Should non-citizens of America still fit under the American laws surrounding this issue? Why or why not?




http://www.aegis.com/pubs/bala/1992/ba921008.html<span style="mso-tab-count: 1">
Sonali Mehta 5/28/08
The author of the webpage works for the Being Alive newsletter, which is circulated to Los Angeles in California. The webpage’s date is October of 1992; however, this is okay because it deals with legal aspects of insurance coverage, which makes it valid even 16 years later. The paper does not have a point of view; it seems that way because the purpose of the paper is to outline illegal actions against AIDS patients by insurance companies, but the paper is not biased in any way. There is no opinion in the paper, and it is meant to be an in-depth analysis, and it does a great job of completely covering any topics related to illegal actions taken by insurance companies. The purpose of the information is to inform people. It has no bias, and does not endorse any organization or bill or petition against these actions. Overall, this was a great website for people interested in the topic of legal issues regarding AIDS and insurance coverage. It was good because, though deficient in the visual category, it managed to keep the reader’s attention in spite of the objectivity and dry subject matter. I personally learned a lot from it because of its lack of complication, verbosity, or endorsement of a certain advocacy. I think that the lack of bias, opinion, or endorsement eliminates all kind of distractions and really keeps the reader focused on the issue at hand. The article looks daunting, but it really is not too wordy or complicated or confusing. The information is accurate, believable, and it makes sense. There are no contradictions in the article. I do recommend this webpage.


http://www.mayoclinic.com/health/hiv-aids/DS00005
Priyanka Kapadia Reviewed 5/28/08
This article was published by the Mayo Clinic staff about HIV/AIDS. The information was last updated on January 30th, 2008. This in-depth analysis of AIDS describes what the infection is, how it is caused, what it does, and everything in between. The article is not opinionated in any which way and strictly states the accurate and true information. The facts may seem false because they are mind boggling but inevitably they are completely true. The purpose of this site is to inform and answer any questions about HIV/AIDS. The article thoroughly explains what there is to know about AIDS and is clearly stated and organized. I would recommend this website to peers interested in this topic because it is both informative and captivating. It discusses in great detail every aspect of the infection and its occurrence. It was extremely helpful and aided us through our wiki.


SOURCES
http://www.hhs.gov/ocr/aids.html
http://www.aegis.com/pubs/bala/1992/ba921008.html
http://www.mayoclinic.com/health/hiv-aids/DS00005
http://www.health.state.ri.us/hiv/laws.php
http://www.thebody.com/index/govt/medicare_arc.html