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disclosing status to doctor/employer
Jun 9, 2001

I've been HIV+ for at least fifteen years, am completely asymptomatic, and have undergone no mainstream medical treatment whatsoever. Up until this year I was self-employed but now I work for a small firm and have health insurance through my employer. I want to get a complete physical (my first since the diagnosis) to check for things like prostate cancer, heart disease, etc. and would like to avoid telling the doctor my HIV status. Is this possible? Can he order an HIV test without my consent? I don't want the insurance company to find out and I also don't want to open a can of worms with the doctor. I don't want to start treatment for HIV but I do want to check for cancer and other conditions. Thank you for any advice you can give.

Response from Ms. Breuer

Let's begin by assuming that you have some choice about which doctor you see. You could ask others in the company about doctors they've seen and how much confidence they have in him/her. But a better course is to request a specialist in infectious diseases. According to several studies, how long someone with HIV lives is related to how much his/her doctor knows about HIV, although you seem to be doing very well.

Find out what happens to health insurance claims under your plan. Do they go directly to a clerk in the HR deparment? To the officer of the company who handles health insurance along with a lot of other areas? Or to an insurance company that manages the policy for the employer and submits summary reports (without names and diagnoses) to the employer? The last way is the most professional and the cleanest. If you learn that it's the final one, make the appointment without concern.

Anything you tell your doctor is confidential. Medical professionals cannot reveal diagnoses to employers without the employee's permission, and you can certainly remind your doctor of that. An infectious disease specialist is more likely than others to be mindful of that.

No, the HIV test cannot be done without your written consent. But you'll get the best health care if you're honest with your doctor. HIV can affect cardiac health, the digestive system, and other systems too numerous to list. If you don't want treatment for HIV, you don't have to take it. Doctors can recommend treatment, but they can't order you to take it.

By all means, get that checkup. If claims go directly to the company rather than to a third party, go to a local clinic or hospital for a complete physical and don't claim it on your insurance. A few hundred dollars out of pocket is better than a lost job.

I wish there were a better answer.



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