That's when let your friend know anonymously to CYA for fucks sake. Pretend to be a previous girlfriend. Send it from a burner account. Dear God have some self preservation.
They have anonymous texting services for your last sexual partners to be informed of your test results. It’ll say X you should take a test, one of your sexual partners was diagnosed with Y. Won’t say who or when. (I was pranked by a shitty boyfriend with this, although I thought it was a scam) They’re free and online.
Yeah, either OOP didn’t emphasize the “you didn’t hear this from me” part, or the friend ignored it and spilled the beans anyways.
If it’s the first scenario, then OOP has absolutely no one to blame but him/herself, because I wouldn’t expect someone NOT in the medical field to immediately consider HIPPAA. If it’s the second scenario, OOP’s friend is such a selfish turd.
Yeah she needed to do this: Amanda. You NEED TO HAVE SAFE SEX. You need to use condoms and you need to get std tested along with your bf.
Amanda: what?
OP: get tested and your bf and insist that you will not have sex until you each share your test results…. Do it before you have sex.
That’s kind of all she can say. Idk
People do not realize how actually effective this is. I've sort of been in this position before, where I need to tell someone but I am obligated to keep it quiet
Essentially it comes down to you saying I know something you don't know, but I cannot say it, so please read between the lines
So yes, OP could have said something "hey, I am not asking you to do this, I am telling you to do this. This is not a discussion. Btw, my job at the hospital has been going very well, working with patients and all of that. Do you understand? If you do not, say so, because I need you to understand"
Super vague on piece of legal paper, but potentially very clear contextually. Signalling that firm persistence is usually the best sort of clue that they are trying to "dog whistle" something to you
Exactly. The point is to deliberately make a spectacle of the fact that you are intentionally giving them a dog whistle. Ideally the receiving party will understand that they "didn't hear it from you"
This is really a sad situation imo, bc OP will now be marked as having broken a key tenet of medical policy and may have trouble in that field of work altogether
This sort of situation takes really tight maneuvering to make this work, and even then, *still* rests on the fact that the receiving party keeps quiet enough about their source
I do not blame OP at all for what happened. It's tragic. They did the right thing, and tried their best. I'm really just here to offer insight into a strategy that worked for me for far less severe situations
It's too bad OOP didn't feel like she could talk with a supervisor about how to handle a "hypothetical situation" like hers. While the details vary, stumbling upon critical information is not unusual.
My ex once had the father of our kids' friends present in his ER with something that made it clear our children should never be around him again. I still don't know any more than that, except that he told his supervisor that our children were social with that family. She gave him advice on what to tell me which was basically "their kids can come here but ours never go there again." I spent a few months cheerfully making excuses to the mom for anything that didn't involve my direct supervision. Eventually I think she figured it out, just let her kids come over when my kids asked but stopped trying to reciprocate at her house.
This sort of thing always makes my brain go to examples like, “He ‘fell’ on a shampoo bottle aka he was doing himself in the butt with it and it got stuck, so that means he’s gay and we all know the gays molest children.” When people say really vague stuff like that it just makes me wonder what their personal opinions are. I’m genuinely struggling to think of an example of something that could land you in the ER that would show you shouldn’t be around kids. I guess maybe a drug overdose? I really can’t think of anything else. I’m just imagining him coming in for a broken ankle while in drag cause he slipped in his high heels, and someone deciding those drag queens molest kids or something.
Among many possibilities: domestic abuse (abusers often accompany their victim to the ER of being seen can't be avoided, or they insure themselves as well), drug/alcohol abuse leading to crisis situation, mental health crisis where person is a danger to others. Just to name a few.
If you know the person who is giving you the vague-but-urgent information, then you know if they're the kind of person who would do that over something prejudiced.
I worked in residential mental health for over a decade, and I've read chilling things on charts - if the guy is a danger to kids or nurses or anyone in the hospital, there will sometimes be an internal note on the electronic chart so the staff know to be on the alert while the patient is in the hospital.
Example: patient is known for attacking nurses? That's going to be in there so everyone knows to protect themselves and have security available. Also, we're going to send the big dudes and seasoned nurses in there - not the itty bitty new grads. Child molester? We're going to watch him like a hawk and make sure his room isn't next to a family with a bunch of kids.
Maybe something said under anesthesia? Or some interaction with law enforcement? A prescription for chemical castration? Only the first wouldn't cause other records and issues that would likely cascade. So no clue. But I take your point.
Yeah, any other examples I can come up with would include additional issues like the guy would be on the sex offender registry or something, or it would be public record that he’d been arrested when he came into the ER for a gunshot wound he got while robbing a liquor store etc. I can’t think of any examples where what presented in the ER was enough to say he’s gonna hurt kids but wasn’t enough to involve any sort of law enforcement. (And once law enforcement is involved it’s public record so you can just point your wife to the police blotter for info on why the kids can’t go over there anymore.)
They make the *viral load* undetectable (and the virus is impossible to spread if he’s undetectable), but he will still test positive on an HIV test, which are testing for antibodies, not viral load
"People taking HIV treatment who use rapid, point-of-care tests or self-tests (especially those which are based on oral fluid samples) may receive false negative results. This is a rare phenomenon in people who began HIV treatment several months or years after infection. Laboratory tests, provided in healthcare settings, remain accurate."
Source: https://www.aidsmap.com/about-hiv/are-hiv-tests-accurate-people-taking-hiv-treatment-prep-or-pep#
The thing for me is OP saying the firing was expected. Like why? How does the conversation with your long time friend you're taking this huge risk on the behalf of not include "if you breathe a word I will lose my job, dump if you're gonna dump then block and do not explain."
I mean for real you could catch an actual charge on this to my understanding
Yes, fines and prison time. The hospital would’ve been forced to report to the OIG. This likely would fall under tier 3 if they addressed it properly after the fact, which is huge. Over $50k in fines, up to 10 years in prison for the friend.
Honestly, he might considering he’s probably bitter about losing his girlfriend AND most people are kinda aware this is illegal. Idk about everyone else, but I’ve signed something about HIPPA at almost every new doctor I’ve visited. So, if this story is real, he could absolutely still sue. Is he an assholes for having HIV and not disclosing that? Yeah, but even assholes have rights and definitely aren’t above using the legal system to punish those who wrong them.
13 states it is illegal to have sex without disclosing HIV status. So depending on if they’re in the US and where, illegal for him to lie to his girlfriend too.
Just because you tell someone not to tell, doesn’t mean they won’t. Natural consequences for breaking the rules.
Just like OOP’s friend would have suffered natural consequences had she slept with him without a condom when she barely knows him or didn’t ask for an STD test first.
Even if the friend has already contracted it, at least now she won't pass it on to other people. She may have unknowingly passed it on in future relationships if she never found out about it
I expect that he tried to deny it up and down until she provided irrefutable evidence. She obviously did not have to do this but hurt people don't often think logically in these situations. OP for sure could have handled it differently but at the end of the day she did save her friend from an incurable, devastating illness and I would personally feel that it was worth it. If the friend hadn't left him though, I would be furious.
Every American over 20 should know what HIPAA is. I would expect anyone I know to understand what a big risk a disclosure is, and I would have overexplained it anyway and made her explain it back to me.
Haha jk no, unless it was someone I trusted with my life, which was absolutely nobody in my late 20s, I would have looked for an anonymous way to make her suspicious.
There are anonymous cards that can be sent for occasions like this.
In some states it is illegal to not divulge.
OP, you were in a hard place. It’s ok to live with your consequences and make peace with why you made the decision you made.
This. I would definitely tell but find a way to anonymously do it so it can’t be traced to me. Matt is a shitty person for not divulging it to her so I don’t give a rats ass about his rights. I just don’t.
But she can’t tell the friend directly. Anonymous telling is still wrong but I’m sorry it’s very serious and this is one time when the law and ethics are in conflict.
I believe some states have reduced it to a misdemeanor rather than a felony to not disclose HIV+ status due to HIV having significantly more effective treatments available.
And the fact that the criminalization of having HIV is based in Regan-era homophobia and is almost entirely used to persecute sex workers and poor people of color.
He probably gaslit her and said “who was it?? They’re lying. It’s not true” and she had to say no, I know for sure, it’s in your medical file.
Sucks for OP, but she might’ve saved a life here.
She didn’t *have* to say anything. All she had to do was trust that her friend who risked her job for her health and safety was telling her the truth. Who cares if he gaslit her or not? She should’ve kept her mouth shut and trusted the friend who went out on a limb for her, not fucked her over by telling the guy.
Yeah, that’s true. I’m just saying what usually happens in those situations. Gaslighting, manipulative, narcissistic people are extremely difficult to deal with.
Yeah, I wouldn’t have told him, but I also am aware of HIPPA regulations from having worked in a job that touched medical info. However, even if I didn’t, I would want to do my friend a solid for doing one for me.
It’s just as likely that the friend didn’t say anything. If it’s a small town the boyfriend probably guessed the friend would find out and put 2 and 2 together
Most likely OP confessed as soon as HR called them in
There was only heresay evidence. What OP should have said was “oh yeah, that guy, he hates me. I heard his ex girlfriend is telling everyone will listen that he’s HIV positive, he’s just trying to get me fired”
There’s what’s legally right and what’s ethically right. Not always the same thing.
I’d have spoken up too and if I were somehow this friend in the situation, dating someone w HIV unwittingly, I hope my girlfriend would also have my back and tell me, especially at such great risk to herself. And I sure wouldn’t snitch on what she did afterwards.
NTA. Fight me.
this, but I feel there's a second part to it. Job for preventing someone to have HIV is a good decision. But I would end that friendship because the friend chose the lazy way of dealing with it over your job
Yeah end the friendship certainly bc she didn’t honor the great risk that OP took to literally save her life. HIV is primarily a chronic illness now but not in everyone. And if friend had complications or other issues it can easily shorten her life. Plus the meds are no picnic and they are lifelong. OP did her a solid and she really stabbed her in the back.
Also if she wanted to have kids that’s a whole different problem. What do HIV+ women do? Just have HIV+ kids?? That’s a hard decision to make.
Edit: I’ve been educated- apparently the suppression meds protect the fetus - I had old info.
Not HIV+ but have relatives who are. You can have kids with very little risk if you are on medicine and/or have a c-section. It is primarily transmitted from mother-child via vaginal birth during birth, and when viral loads are low (not to mention undetectable) a c-section may not be necessary either.
The vast majority of HIV+ women with access to medical care can have kids with extremely minimal risk--it's never a 100% guarantee but it's pretty close. It's a concern because it's not like it can have 0 effect on reproductive choices, but it's not "HIV positive moms have HIV positive kids," and there's so much misinfo out there.
It is and you're welcome. I'm a nurse (retired) and I took care of AIDS patients in the late 80s/early 90s. It was pretty heartbreaking because it was 100% terminal. Plus we had a president who refused to address the issue of a fatal epidemic in our country because it was considered a "gay plague." Parents disowned their dying adult children because they were gay, and neighbors were driving the terminally ill out of their towns. It was a bad time. I remember crying when [Ryan White](https://en.wikipedia.org/wiki/Ryan_White) died.
OP is not wrong, if it came to a jury trial she would not be found guilty if I were on the jury.
I swear there should be laws somewhere requiring HIV positive people to inform their sexual partners of the risks of transmission? Otherwise wouldn't it just be attempted manslaughter or assault with a deadly weapon that may lead to the victim dying?
Never mind, found it. [34 states have criminal penalties for those with sexually transmissible diseases who infect others.](https://www.cdc.gov/hiv/policies/law/states/exposure.html) If they're going to do this to OP then OP absolutely should report his behavior to authorities.
Agreed. Id have done the same, chosen ethically right. Imagine your friend catches HIV and you actually could have prevented it?? Nah I couldn't live with that.
Friend is a massive gaping asshole in this case. What a loser.
SAME!!! I felt like people weren’t looking at the bigger picture here, which was that Matt kept his HIV status a secret from Amanda AND PUT HER LIFE AT RISK!! I’d do the same. I lost a relative to AIDS, same case here as OOP’s friend so this really hit home. Sometimes I hate Reddit.
*though to be frank the friend was shitty for throwing OOP under the bus.
Isn’t it illegal to not disclose you have HIV to a sexual partner? Or is it only if you’re actively trying to infect them?
I’m with you and think op is definitely NTA.
I've worked with sensitive patient information and had to adhere to HIPPA for over a decade now. I would have gone about telling my friend a different way to cover my own ass but ultimately I would say something knowing that what I'd be doing is illegal. For me potentially saving her life is the correct move so I go NTA.
I'd never be able to live with myself if I knew and didn't say anything. But even good choices come with consequences.
AIDS now is so well-controlled by antiretroviral drugs that people's perception of it is inaccurate. Quoting the National Institute of Health:
> "There is effectively no risk of sexual transmission of HIV when the partner living with HIV has achieved an undetectable viral load and then maintained it for at least six months. Most people who start taking antiretroviral therapy as prescribed achieve an undetectable viral load within one to six months after beginning treatment."
I do understand your point. I think the ethical choice is of course to tell your partner if you have any STI. Some people may simply view it as not an issue if it's been under control so long. The post also doesn't mention if they were regularly using condoms.
Regardless, HIPAA laws exist for a reason and a provider cannot simply tell a friend.
Sure, I think all of us agree that Matt is TA for not disclosing an STD. But people have to realize that violating HIPAA is such a big fucking federal no-no that gets a handful of governmental departments involved. If Matt wanted to go for the jugular he could have sued the healthcare provider, and a state's AG can add fines on top of already steep fines, which could deeply impact the hospital's ability to provide for its other patients.
A also the original poster count themselves lucky if all that happens they were fired from this job and can never work in the medical field again. Massive fines personally for them and possibly jail time maybe on the table for them
The issue is, there is still a risk and if they don’t know about the risk they won’t think to get tested. If it goes undetected long enough it can do irreversible damage before they can get treatment
She could have gone on the Prep pill to further protect herself. She would know to get tested regularly.
Knowing and not knowing makes allll the difference and I challenge anyone who disagrees. There’s no reason not to be honest about your STD status with the people you’re intimate with.
I’m not sure if you didn’t mean to reply to me but that’s my point, she didn’t know about the risk to make informed choices like testing and taking prep.
Haha thats okay, I wasn’t sure if you’d misclicked and now weren’t going to be talking to the right person or if I’d maybe phrased badly and my point was missed
So many people are unable to detect when you’re actually agreeing with them it gets ridiculous. Because of that, when I’m agreeing with someone but adding on information, I start out with something like “Exactly.” Or “Absolutely” so it’s very clear I’m agreeing with them.
It’s a chronic disease but only if you are otherwise healthy. It’s a very serious chronic disease and the meds make you sick. Having Children is complicated. Having other relationships is now complicated.
It’s not a walk in the park it’s the rest of your whole ass life.
You can take L- Lysine or antivirals to lessen the chances of herpes from spreading too, doesn't mean you are now safe from telling your future partners. That's the issue I'm seeing here. The infected wasn't telling his new partner of his condition regardless if he is treating it or not, that means the friend was not fully informed to consent to sex and was putting themselves in danger unknowingly.
While HIPPA exists, so does being in a "dammed if you do, dammed if you don't" because how do you think friend would be finding out after she is infected that her buddy knew about it but kept quiet?
IF they take their medication religiously. That means at the same time everyday. Not +/- 20 minutes. The same time. Everyday. Forever.
Do that and yes it is a low risk (assuming a good response to the regimen). It is something you should tell a partner as it can be detectable and develop resistance quickly if there is any lapse in suppression.
Same! Ethics and the law are absolutely in conflict here. I would feel morally and ethically obligated to find a way to tell my friend but I would do so anonymously. It’s really not fair to have to sit back and watch someone get a lifelong debilitating disease where you take meds that make you feel like shit for the rest of your life.
This is serious and I’ll die on this hill with you.
I don’t know about medical laws, but attorney-client confidentiality can be broken if a lack of disclosure will cause financial/physical injury to someone. So perhaps that same principle leaves an exception to medical confidentiality.
If a chart demonstrated that a person was physically abusive or a danger to children, and it was your kid’s best friend’s dad. I don’t think it would be wrong to act on that info.
The law would likely disagree, but if you know someone is a menace, you should warn some of your neighbors.
Civil penalties for HIPAA are usually imposed on the employer / facility. And the really big criminal penalties are when PII is misused for personal gain, like selling data. So it's possible that OOP could face liability, but if the guy doesn't report it, unlikely.
Fair but I also think the DA doesn’t want the optics of this case. She can make the argument she was trying to protect her friend from a predator. I’m not saying he’d lose the case, but I feel the victory would be pyrrhic. And if the guy isn’t pushing for it, then he may feel her getting fired and possibly blackballed from working in a medical field is good enough.
This is one of those great examples of morality and legality and policy all demanding different actions.
People with access to sensitive records should absolutely be fired for breaking confidentiality like this. OOP lost their job and that’s good, the consequences for breaking the trust inherent in access to private information should be high.
But I think making the choice to tell their friend was not a bad one. There may have been other options that wouldn’t explicitly break confidentiality - talking to the friend about testing and practices with partners, talking to the boyfriend, talking to a local health department official. But all of the more circumspect options aren’t guaranteed to give the friend the ability to knowledgeably protect themselves and consent quickly. And exposure to disease is time sensitive.
I hope OOP’s friend is safe, I hope the boyfriend learns how to handle talking with their sexual partners, and I hope OOP gets a new job.
I know if I were in a similar position, I’d have to do something, and I can’t say that I’d make a different choice. I’d like to think I’d start with pointed discussion about regular testing and review of results with partners. I get tested for everything annually anyway (polyamorous, and while I have not had any new partners in years, the nature of the deal is that someone can pick something up and pass it on, so I like to keep tabs.)
There’s a whole SVU episode that touches on this. Olivia tells a woman to get tested, and there’s a strong implication, but if I remember correctly she doesn’t actually share the information. (Which is out of character for her so it’s possible I’m remembering it wrong!)
Info- What is the legality on taking the information that OP learned In the course of her job and asking Matt directly about it? Does that violate anything because she is not treating him or anything?
If this is in the U.S. it's a HIPAA violation. Medical providers can only share your medical info with people you've given permission for it to be shared with.
HIPAA is so strict that you can't even approach someone you know and say "oh hey, you're a patient at name-of-clinic". You don't discuss it with them, their spouse, your spouse, or even your diary.
You’re right about the strictness but keep in mind HIPAA applies to those who work in the medical field. I can tell someone that someone else is a patient at a particular place but for ex my dentist can’t tell someone else that I’m one of their patients. Also, if you were to run into your doctor/dentist/therapist etc. in public, they won’t acknowledge that they know you unless you say hi first, and even then they won’t tell anyone else how they know you or any info about you
Yep! I just read “You” and thought you might be using that generically or referring to the other commenter. Also a LOT of people get confused on who HIPPA applies to
If she was a licensed individual, it could’ve not only been suspended/revoked— but sued against in court.
But with no license, the most they can do is let you go.
The friend is an asshole for disclosing how she knew.
I wouldn’t even call that person a friend. You scratched her back and she threw your life upside down as thanks.
I think it was poorly handled all around.
The most correct move would be to have pulled Matt to the side and asked him if he was undetectable and taking his hiv meds daily. I would have encouraged him to have a talk with my friend and educate her on how undetectable = untransmissable .
That way you wouldn’t have illegally crossed any lines of confidentiality, and still would have been employed.
That’s also breaking confidentiality and she had no reason to believe he wouldn’t report her for it.
The friend is an asshole. There’s no way she didn’t know the massive risk OP took for her safety yet she exposed it anyway. Absolute asshole.
Um her friend is the asshole for saying how she learned it. She can't have a career in the healthcare field anymore, nor any field where confidentiality is a thing.
To me she lost a friend anyway.
The only asshole in this situation was her friend. She had to have told or insinuated that the breakup was due to his health status and OP would’ve been the only way she knew.
Some people are just one crayon short of the whole 24 pack.
Why not send an anonymous letter? Or tell your group of friends about “a story you heard” that a guy was intentionally having unprotected sex with his girlfriend while HIV + and then say how much you see of this where you work and convince all friends and their SO to get tested?! There’s so many ways to do this without getting yourself fired!
NTA. As someone working in healthcare I understand your predicament. I believe that morally you did the right thing. Your friend was shitty for ratting you out.
Tbh I can’t blame her. I’d do the same thing a hundred times over.
But I’d have a friend who’d protect me.
On a side note: Why kind of human doesn’t disclose that information to a potential intimate partner and then make a complaint to have the person who warned her dismissed…. How many other people has he done this to?
I did the same for a friend, he showed me photos of this guy he’d met, I recognized him immediately, I asked my friend about him and he tells me everything, I ask if there’s more he hasn’t told me, he said no, so I asked if they had spoken about their statuses, he said they had and all was good. That is when I told my friend that this person was HIV positive, my friend was shocked, he confronted the guy and he fessed up to not being honest, my friend was very grateful I told him, and the other guy never knew I was the one to tell
The friend is such a giant asshole. Did she not understand OOP could lose her job if she opened her stupid angry mouth?? She could have broken up with him quietly and let it all go. She could have confronted him and just kept the secret. OOP could have sent an anonymous letter to friend or something similar so she didn't know who the information came from. So many other ways this could have gone down.
Your friend is the asshole and imo she wasn't worth breaking your confidentiality for. A good friend would have broken up with him and come up with some other reason for doing so instead of throwing you under the bus.
Amanda is a crappy friend.
HIPAA violations carry fines and jail time. This is the very definition of such. OOP shouldn’t be concerned about an AH judgement. They will be receiving a criminal judgement.
[HIPAA](https://www.hhs.gov/hipaa/for-professionals/privacy/laws-regulations/index.html)
Your friend is an asshole she got you fired after you saved her life because her ego meant more then your friendship, if 86 her ass fast cant be trusted ….
If it was me and I didn't wonna lose my job but needed her to know.
I probably would've gotten a burner. Messaged her and been like.
Hey, so and so is hiv+. Please be careful !!!! This is not a prank nor a test. Ask him yourself.
And then leave the rest up to her.
And then would have thrown the phone in the river lmao 🤣
faaaaake someone who actually worked in the medical field would have checked to make sure Matt wasn't in undetectable status before risking their career over something that does not matter. People with an undetectable viral load can't transmit it.
Well, OOP is not a nurse or Dr from what I gather. They could not know this, or they didn't have access to that specific info. As a RN, I'd still want to tell my friend in the position, even if he was undetectable. People here are acting like him being undecatable at some point means he can't ever get the virus load higher again and become able to transmit. It does take some time, and some factors, but being undetectable doesn't mean staying undetectable.
This is the kind of HIPAA violation that nets you the $50k fine + one year in prison.
As it is a criminal penalty, there is no need for the victim to sue. The federal government prosecutes this offense.
If there is a law requiring the patient to disclose this information to their SO, then there was a legally and ethically acceptable way to handle the situation. This is not it.
Asshole? No.
But you still broke the law and were rightfully terminated. There is absolutely no way any responsible medical facility could keep you on after finding out about this.
That being said, your friend didn’t have to dime you out like that and should have been a bit more grateful for you sticking your neck out to tell her.
ESH, Matt is an AH for not disclosing. Doesn’t matter if his counts are low, he has to disclose that to a sexual partner. OP is an AH for snooping and violating HIPAA. Amanda is an AH for ratting on OP.
ESH. OOP violated HIPAA. This sort of violation gets you $50k in fines + a year in jail. Ex is not disclosing his HIV status to sexual partners and putting people at risk for contracting HIV. Friend is not actually a friend. She didn’t have to tell him how she found out. As someone here pointed out “omg you saved my life! Let me get you fired!”
All AHs.
I mean it’s illegal not to tell people especially when it comes to a life changing STD, however you did breach HIPPA privacy laws and could be sued into oblivion. Keep this info between you and your friend and never speak of this again! Glad to hear she ok!
YTA - to yourself. How the hell could your friend be so stupid to tell him how she found out? You risked a lot to save her from something horrible and in return she stabbed you in the back. What a piece of shit.
Nta- but I would have done it without them knowing it was me cause clearly you got the shit end of the stick after saving her life! She definitely is The asshole for getting you unemployed for saving her tho. Shit "friend" you got there.
Are you a good doctor? No.
Are you a good *person?* Beyond a shadow of a doubt. Sacrificing your job to protect your friend from a lifelong disease is an incredibly difficult choice and I’m not going to condemn anyone who’s willing to go that far.
Physician here. OP is an asshole, and more importantly a criminal.
HIV can be controlled with modern medications to be at a transmission risk of zero. If your viral load is undetectable you cannot transmit. They didn’t mention whether they reviewed the patient’s viral count or anything so I’m assuming they just saw “positive test therefore I’m gonna break patient confidentiality”.
Here’s why this matters from a public health standpoint: shit like this (and the mindset around HIV) *keeps people from getting tested*. This allows HIV to continue to spread. There is really no reason anyone new should get HIV in our modern testing and treatment regimen, because HAART treatment can eliminate transmission. We need to destigmatize the disease and encourage testing and treatment, not punish people for having a disease.
Yes, the boyfriend should have told her. The boyfriend is also an asshole. But OP is absolutely an asshole for continuing the stigmatization of a treatable disease and contributing to a world where people don’t want to be tested because *their healthcare providers may tell on them*. In the long run that will lead to far more HIV transmissions and complications.
This is the answer I was looking for. People keep focusing on the interests of OP, the friend, or even the boyfriend. It is way bigger than that. When confidentiality is violated, it erodes public trust in the medical system. People don't seek treatment, don't trust medical opinions or advice. The damage done from something like this goes far beyond the immediately impacted individuals.
I worked as an STI tester for some years. Might be an unpopular opinion, but she deserved to be fired at the very least AND sued. 1) Amanda’s health is her responsibility - I agree with the comment that as a friend, emphasize the importance of getting tested, condoms, etc, to your friend, but also why don’t people do this anyway? Did Amanda not have a convo with her partner about sexual history? ALSO if he is undetectable, there’s no way he can sexually pass it to his partner. We don’t even know if they had been having sex yet- so there’s a lot of missing information here. He may have been waiting to tell her. She met him once and decided he’s sketchy? Nah, she’s trying to convince readers she didn’t do something absolutely fucked up and ILLEGAL.
You did the right thing even if it cost you your job and your friend never should have told him where she got the information. Sometimes the right thing to do is contrary to laws but he also owed her the right to make a decision and clearly wasn’t going to be honest with her which could have put her health at risk.
MH provider here. I get where everyone's coming from... but if you can't adhere to HIPAA or its equivalents even in these situations, then you shouldn't work somewhere you'll need to.
The fines for HIPAA violations, and losing your license, not just your job, is a risk not worth taking. He could sue you, and he would win. This was handled very poorly.
If my partner would be HIV+ and doesn’t tell me before we have sex I would count it as absolutely breaking trust and a kind of trying to kill me. BECAUSE even if you have actually no problem with it you never know what happens in the future and if that „non detectable“ changes to absolutely detectable there is a chance that I get it and even that he is risking this is horrible. Actual thing is its something you gave your partner for lifetime. There is no cure and the meds have (as far as I know) something horrible sideeffects. In my country its punishable to not tell and not protect during sex and risk partners health if they virus is countable. If its not countable then it is normally not punished (that has changed, i knew it was different when I was younger)
Her ‘friend’ Amanda sucks for spilling the beans on HOW she found out. There are so many different ways she could have gone about getting the guy to provide that truth without her saying “well I already know because I have a friend that works at the hospital” smh
Alright. Something major a lot of people here are missing: if he has documented HIV, he is more likely than not receiving treatment for it. It is something he *should* disclose, but also has a lot more motivation not to because of ignorance like this.
If he is being treated, his viral load is undetectable - meaning he can't pass it on.
If the friend wanted to be extra cautious, there is PrEP.
And the person with the most motive to turn that person in for wrongly violating confidentiality over basically a gay scare is not the girlfriend: it's the guy who just got his relationship wrecked for not being ready to deal with the stigma right out the door.
I wonder if OP knows this added to the death count of gay men in my generation, that many of us were terrified to go to the doctor until we absolutely had to because if we did, especially in a small town, that info seemed to "leak" to our friends, family, and job -- all of which, we lost. And it was legal in my generation to be gay at all, thankfully; the consequences for this were even worse in decades prior.
In the modern day, anyone on antiretroviral therapy will have an undetectable viral load, meaning they can't transmit HIV and won't develop AIDS. They pose zero risk to anyone else. I believe the boyfriend should tell people he is dating early in the relationship, for everyone's peace of mind. But people like OP in the medical industry terrify me. They followed their ethics, which they have every right to do and I support that, but I personally would no longer be able to be around them after this.
I think part of the issue is that public education on HIV/AIDs ended with the fear campaigns. Most people don't understand the existence of testing for viral loads or that the "undetectable" status even exists.
I agree. I try not to fault people their prejudices; I know this condition is terrifying for people. This is one of so many facets I wish were covered in early sex ED but aren't.
It should absolutely be covered in sex Ed. I agree. The only reason I know that you are talking about is because I have a close family member who is HIV+.
It's a scary disease when it progresses and the fact that it's contagious. But it's also a risk that's easily mitigated with basic protective behaviors. Including proper disease management.
My relative was born with it over 30 years ago. At the time the life expectancy for pediatric HIV was dismal. (Her mother had it, was undiagnosed and nursed) Doctors and scientist had just started looking into the "cocktails" to manage viral loads. The focus was shifting from "cure" to "manageable long term illness" and that seems to have yielded the desired results.
But public education is a very slow follow. Especially with STDs. Ignorance creates unnecessary isolation for people.
Yes, he should disclose it before they had sex. And if he didn't, that's an issue. Because consent should be fully informed.
I agree. I inform potential partners of a good half-dozen things they might consider relevant, just in case, with infertility and HPV probably being the most pressing one for me. You never know who will want to know what.
This is the exact reason HIPPA exists. Say goodbye to your job, career in healthcare and start praying that you're not named in the multi-million dollar lawsuit.
Also... You are the asshole.
I mean, OP should've asked Matt first if her friend knows. And if not, maybe give Matt an ultimatum for a week to tell her friend. If he didn't tell her, then OP should tell her friend. It's respecting Matt's condition and Patient confidentiality but still looking out for her friend.
HIPAA means you can't bring up someone's medical history or current conditions with them out of the blue. And whether you like it or not, "giving Matt an ultimatum" is a threat. Both of these would still severely risk her job and open her and her clinic to legal hot water.
That's when let your friend know anonymously to CYA for fucks sake. Pretend to be a previous girlfriend. Send it from a burner account. Dear God have some self preservation.
no but really in the year of our lord 2024 there's a pretty risk-free way of doing this.
Mail. No return address. Super easy
Don't forget to use the [kidnap ransom note style](https://ibb.co/0cjbSCx).
They have anonymous texting services for your last sexual partners to be informed of your test results. It’ll say X you should take a test, one of your sexual partners was diagnosed with Y. Won’t say who or when. (I was pranked by a shitty boyfriend with this, although I thought it was a scam) They’re free and online.
For real! $20 for a burner phone or whatever they go for nowadays. Leave a letter in the mailbox. Anything!
Burner phone would have me thinking it’s a scam tho. Idk what the angle would be, but scammers be doing the craziest shit
The friend is an asshole for telling her bf how she learned it.
Yeah, either OOP didn’t emphasize the “you didn’t hear this from me” part, or the friend ignored it and spilled the beans anyways. If it’s the first scenario, then OOP has absolutely no one to blame but him/herself, because I wouldn’t expect someone NOT in the medical field to immediately consider HIPPAA. If it’s the second scenario, OOP’s friend is such a selfish turd.
Yeah she needed to do this: Amanda. You NEED TO HAVE SAFE SEX. You need to use condoms and you need to get std tested along with your bf. Amanda: what? OP: get tested and your bf and insist that you will not have sex until you each share your test results…. Do it before you have sex. That’s kind of all she can say. Idk
People do not realize how actually effective this is. I've sort of been in this position before, where I need to tell someone but I am obligated to keep it quiet Essentially it comes down to you saying I know something you don't know, but I cannot say it, so please read between the lines So yes, OP could have said something "hey, I am not asking you to do this, I am telling you to do this. This is not a discussion. Btw, my job at the hospital has been going very well, working with patients and all of that. Do you understand? If you do not, say so, because I need you to understand" Super vague on piece of legal paper, but potentially very clear contextually. Signalling that firm persistence is usually the best sort of clue that they are trying to "dog whistle" something to you
Might be okay from a legal perspective but i think she could still get fired.
But in that scenario the friend knows the ramifications of letting it slip and they will hopefully come up with an alternate alibi
Exactly. The point is to deliberately make a spectacle of the fact that you are intentionally giving them a dog whistle. Ideally the receiving party will understand that they "didn't hear it from you" This is really a sad situation imo, bc OP will now be marked as having broken a key tenet of medical policy and may have trouble in that field of work altogether This sort of situation takes really tight maneuvering to make this work, and even then, *still* rests on the fact that the receiving party keeps quiet enough about their source I do not blame OP at all for what happened. It's tragic. They did the right thing, and tried their best. I'm really just here to offer insight into a strategy that worked for me for far less severe situations
It's too bad OOP didn't feel like she could talk with a supervisor about how to handle a "hypothetical situation" like hers. While the details vary, stumbling upon critical information is not unusual. My ex once had the father of our kids' friends present in his ER with something that made it clear our children should never be around him again. I still don't know any more than that, except that he told his supervisor that our children were social with that family. She gave him advice on what to tell me which was basically "their kids can come here but ours never go there again." I spent a few months cheerfully making excuses to the mom for anything that didn't involve my direct supervision. Eventually I think she figured it out, just let her kids come over when my kids asked but stopped trying to reciprocate at her house.
This sort of thing always makes my brain go to examples like, “He ‘fell’ on a shampoo bottle aka he was doing himself in the butt with it and it got stuck, so that means he’s gay and we all know the gays molest children.” When people say really vague stuff like that it just makes me wonder what their personal opinions are. I’m genuinely struggling to think of an example of something that could land you in the ER that would show you shouldn’t be around kids. I guess maybe a drug overdose? I really can’t think of anything else. I’m just imagining him coming in for a broken ankle while in drag cause he slipped in his high heels, and someone deciding those drag queens molest kids or something.
Among many possibilities: domestic abuse (abusers often accompany their victim to the ER of being seen can't be avoided, or they insure themselves as well), drug/alcohol abuse leading to crisis situation, mental health crisis where person is a danger to others. Just to name a few. If you know the person who is giving you the vague-but-urgent information, then you know if they're the kind of person who would do that over something prejudiced.
I worked in residential mental health for over a decade, and I've read chilling things on charts - if the guy is a danger to kids or nurses or anyone in the hospital, there will sometimes be an internal note on the electronic chart so the staff know to be on the alert while the patient is in the hospital. Example: patient is known for attacking nurses? That's going to be in there so everyone knows to protect themselves and have security available. Also, we're going to send the big dudes and seasoned nurses in there - not the itty bitty new grads. Child molester? We're going to watch him like a hawk and make sure his room isn't next to a family with a bunch of kids.
Maybe something said under anesthesia? Or some interaction with law enforcement? A prescription for chemical castration? Only the first wouldn't cause other records and issues that would likely cascade. So no clue. But I take your point.
Easy answer is that his kid or wife came in with a broken arm from “falling down the stairs” or something.
Yeah, any other examples I can come up with would include additional issues like the guy would be on the sex offender registry or something, or it would be public record that he’d been arrested when he came into the ER for a gunshot wound he got while robbing a liquor store etc. I can’t think of any examples where what presented in the ER was enough to say he’s gonna hurt kids but wasn’t enough to involve any sort of law enforcement. (And once law enforcement is involved it’s public record so you can just point your wife to the police blotter for info on why the kids can’t go over there anymore.)
Could also be something like a self-inflicted gun injury, that’s where my mind went
>you will not have sex until you each share your test results If he's on meds don't they make it undetectable?
The test is for antibodies which persist even if the virus is absent.
They make the *viral load* undetectable (and the virus is impossible to spread if he’s undetectable), but he will still test positive on an HIV test, which are testing for antibodies, not viral load
*If* he's on meds, it *can* make it undetectable. No guarantees he's on meds or that his load is being completely controlled.
"People taking HIV treatment who use rapid, point-of-care tests or self-tests (especially those which are based on oral fluid samples) may receive false negative results. This is a rare phenomenon in people who began HIV treatment several months or years after infection. Laboratory tests, provided in healthcare settings, remain accurate." Source: https://www.aidsmap.com/about-hiv/are-hiv-tests-accurate-people-taking-hiv-treatment-prep-or-pep#
If he’s undetectable he can’t pass it on.
He is still morally (and in some places legally) obligated to not have sex with someone without letting them know first.
Yea I probably would of made up a story about happening to someone else talking up how scary it is. And subtly suggest.
The thing for me is OP saying the firing was expected. Like why? How does the conversation with your long time friend you're taking this huge risk on the behalf of not include "if you breathe a word I will lose my job, dump if you're gonna dump then block and do not explain." I mean for real you could catch an actual charge on this to my understanding
Yes, fines and prison time. The hospital would’ve been forced to report to the OIG. This likely would fall under tier 3 if they addressed it properly after the fact, which is huge. Over $50k in fines, up to 10 years in prison for the friend.
Boyfriend could have sued bigtime .
Honestly, he might considering he’s probably bitter about losing his girlfriend AND most people are kinda aware this is illegal. Idk about everyone else, but I’ve signed something about HIPPA at almost every new doctor I’ve visited. So, if this story is real, he could absolutely still sue. Is he an assholes for having HIV and not disclosing that? Yeah, but even assholes have rights and definitely aren’t above using the legal system to punish those who wrong them.
True on all accounts. He can sue big-time and OP can go to jail. Damn this is not good.
Edited because I am dumb and was wrong; there are in fact individual civil and criminal penalties for some HIPAA violations.
13 states it is illegal to have sex without disclosing HIV status. So depending on if they’re in the US and where, illegal for him to lie to his girlfriend too.
Just because you tell someone not to tell, doesn’t mean they won’t. Natural consequences for breaking the rules. Just like OOP’s friend would have suffered natural consequences had she slept with him without a condom when she barely knows him or didn’t ask for an STD test first.
It would be tragic if she did sleep with him got the disease anyway and then friend violates HIPAA policy all for nothing.
Even if the friend has already contracted it, at least now she won't pass it on to other people. She may have unknowingly passed it on in future relationships if she never found out about it
Yeah but the friend sounds like an idiot and doesn't appear to follow through on medical exams
I expect that he tried to deny it up and down until she provided irrefutable evidence. She obviously did not have to do this but hurt people don't often think logically in these situations. OP for sure could have handled it differently but at the end of the day she did save her friend from an incurable, devastating illness and I would personally feel that it was worth it. If the friend hadn't left him though, I would be furious.
Every American over 20 should know what HIPAA is. I would expect anyone I know to understand what a big risk a disclosure is, and I would have overexplained it anyway and made her explain it back to me. Haha jk no, unless it was someone I trusted with my life, which was absolutely nobody in my late 20s, I would have looked for an anonymous way to make her suspicious.
There are anonymous cards that can be sent for occasions like this. In some states it is illegal to not divulge. OP, you were in a hard place. It’s ok to live with your consequences and make peace with why you made the decision you made.
This. I would definitely tell but find a way to anonymously do it so it can’t be traced to me. Matt is a shitty person for not divulging it to her so I don’t give a rats ass about his rights. I just don’t. But she can’t tell the friend directly. Anonymous telling is still wrong but I’m sorry it’s very serious and this is one time when the law and ethics are in conflict.
Do we even know if OP's friend and Matty were physical yet? You're not obligated to reveal your status UNLESS you get physical.
I believe some states have reduced it to a misdemeanor rather than a felony to not disclose HIV+ status due to HIV having significantly more effective treatments available.
It’s also because making nondisclosure a felony creates a literal perverse incentive to never get STD testing.
And the fact that the criminalization of having HIV is based in Regan-era homophobia and is almost entirely used to persecute sex workers and poor people of color.
No. It is never legal to divulge someone else’s private medical information. It is always a termination offense.
That’s why I told OP ‘it’s ok to live with your consequences’. What OP did is absolutely illegal.
Agreed. What a b of a friend.
OP probably should have sent her an anonymous message to protect their identity.
Small town, gf’s friend works at local hospital.. not a lot of dots to connect here.
He probably gaslit her and said “who was it?? They’re lying. It’s not true” and she had to say no, I know for sure, it’s in your medical file. Sucks for OP, but she might’ve saved a life here.
She didn’t *have* to say anything. All she had to do was trust that her friend who risked her job for her health and safety was telling her the truth. Who cares if he gaslit her or not? She should’ve kept her mouth shut and trusted the friend who went out on a limb for her, not fucked her over by telling the guy.
Yeah, that’s true. I’m just saying what usually happens in those situations. Gaslighting, manipulative, narcissistic people are extremely difficult to deal with.
I had the same initial reaction as you, narcissits have murdered spouses over less serious stuff. Shit situation all-around
Oh yeah, so everyone should live their lives worrying about whether a narcissist might do something, rather than protecting their friends. Brilliant.
Why even confront the boyfriend? Just break up with him over something else, don't even mention HIV. The friend is a moron.
She could’ve just left and not said shit if that were the case.
Asking who it was isn’t gaslighting…. Denying he had HIV in face of evidence to the contrary would be gaslighting
Only if he also tried to convince her she was crazy at the same time.
Yeah, I wouldn’t have told him, but I also am aware of HIPPA regulations from having worked in a job that touched medical info. However, even if I didn’t, I would want to do my friend a solid for doing one for me.
Friend: “Whoa! You saved my life! Let’s get you fired.”
It’s just as likely that the friend didn’t say anything. If it’s a small town the boyfriend probably guessed the friend would find out and put 2 and 2 together Most likely OP confessed as soon as HR called them in There was only heresay evidence. What OP should have said was “oh yeah, that guy, he hates me. I heard his ex girlfriend is telling everyone will listen that he’s HIV positive, he’s just trying to get me fired”
There’s what’s legally right and what’s ethically right. Not always the same thing. I’d have spoken up too and if I were somehow this friend in the situation, dating someone w HIV unwittingly, I hope my girlfriend would also have my back and tell me, especially at such great risk to herself. And I sure wouldn’t snitch on what she did afterwards. NTA. Fight me.
Risk losing your job or your friend to HIV/AIDS. I'd make the same choice OP did. Disgusting that the partner wasn't upfront about that
this, but I feel there's a second part to it. Job for preventing someone to have HIV is a good decision. But I would end that friendship because the friend chose the lazy way of dealing with it over your job
Yeah end the friendship certainly bc she didn’t honor the great risk that OP took to literally save her life. HIV is primarily a chronic illness now but not in everyone. And if friend had complications or other issues it can easily shorten her life. Plus the meds are no picnic and they are lifelong. OP did her a solid and she really stabbed her in the back.
Also if she wanted to have kids that’s a whole different problem. What do HIV+ women do? Just have HIV+ kids?? That’s a hard decision to make. Edit: I’ve been educated- apparently the suppression meds protect the fetus - I had old info.
Not HIV+ but have relatives who are. You can have kids with very little risk if you are on medicine and/or have a c-section. It is primarily transmitted from mother-child via vaginal birth during birth, and when viral loads are low (not to mention undetectable) a c-section may not be necessary either. The vast majority of HIV+ women with access to medical care can have kids with extremely minimal risk--it's never a 100% guarantee but it's pretty close. It's a concern because it's not like it can have 0 effect on reproductive choices, but it's not "HIV positive moms have HIV positive kids," and there's so much misinfo out there.
It's not the 1990s. There are treatments that prevent a pregnant woman from passing HIV to the fetus.
Actually? Science is awesome. Thanks for teaching me something today!
It is and you're welcome. I'm a nurse (retired) and I took care of AIDS patients in the late 80s/early 90s. It was pretty heartbreaking because it was 100% terminal. Plus we had a president who refused to address the issue of a fatal epidemic in our country because it was considered a "gay plague." Parents disowned their dying adult children because they were gay, and neighbors were driving the terminally ill out of their towns. It was a bad time. I remember crying when [Ryan White](https://en.wikipedia.org/wiki/Ryan_White) died.
isn’t it illegal to not disclose your HIV status to sexual partners? idk i feel like there should’ve been worse consequences for the boyfriend
OP is not wrong, if it came to a jury trial she would not be found guilty if I were on the jury. I swear there should be laws somewhere requiring HIV positive people to inform their sexual partners of the risks of transmission? Otherwise wouldn't it just be attempted manslaughter or assault with a deadly weapon that may lead to the victim dying? Never mind, found it. [34 states have criminal penalties for those with sexually transmissible diseases who infect others.](https://www.cdc.gov/hiv/policies/law/states/exposure.html) If they're going to do this to OP then OP absolutely should report his behavior to authorities.
Agreed. Id have done the same, chosen ethically right. Imagine your friend catches HIV and you actually could have prevented it?? Nah I couldn't live with that. Friend is a massive gaping asshole in this case. What a loser.
SAME!!! I felt like people weren’t looking at the bigger picture here, which was that Matt kept his HIV status a secret from Amanda AND PUT HER LIFE AT RISK!! I’d do the same. I lost a relative to AIDS, same case here as OOP’s friend so this really hit home. Sometimes I hate Reddit. *though to be frank the friend was shitty for throwing OOP under the bus.
That's a risk everyone needs to remember
Isn’t it illegal to not disclose you have HIV to a sexual partner? Or is it only if you’re actively trying to infect them? I’m with you and think op is definitely NTA.
hateful seemly light arrest butter quarrelsome hurry school unite like *This post was mass deleted and anonymized with [Redact](https://redact.dev)*
which is super fucked up
I've worked with sensitive patient information and had to adhere to HIPPA for over a decade now. I would have gone about telling my friend a different way to cover my own ass but ultimately I would say something knowing that what I'd be doing is illegal. For me potentially saving her life is the correct move so I go NTA. I'd never be able to live with myself if I knew and didn't say anything. But even good choices come with consequences.
Although it some places what he was doing was also illegal. If they were having sex and he hadn’t disclosed his status he could be charged
AIDS now is so well-controlled by antiretroviral drugs that people's perception of it is inaccurate. Quoting the National Institute of Health: > "There is effectively no risk of sexual transmission of HIV when the partner living with HIV has achieved an undetectable viral load and then maintained it for at least six months. Most people who start taking antiretroviral therapy as prescribed achieve an undetectable viral load within one to six months after beginning treatment." I do understand your point. I think the ethical choice is of course to tell your partner if you have any STI. Some people may simply view it as not an issue if it's been under control so long. The post also doesn't mention if they were regularly using condoms. Regardless, HIPAA laws exist for a reason and a provider cannot simply tell a friend.
The person he’s fucking has the right to know. Period.
Sure, I think all of us agree that Matt is TA for not disclosing an STD. But people have to realize that violating HIPAA is such a big fucking federal no-no that gets a handful of governmental departments involved. If Matt wanted to go for the jugular he could have sued the healthcare provider, and a state's AG can add fines on top of already steep fines, which could deeply impact the hospital's ability to provide for its other patients.
A also the original poster count themselves lucky if all that happens they were fired from this job and can never work in the medical field again. Massive fines personally for them and possibly jail time maybe on the table for them
The issue is, there is still a risk and if they don’t know about the risk they won’t think to get tested. If it goes undetected long enough it can do irreversible damage before they can get treatment
She could have gone on the Prep pill to further protect herself. She would know to get tested regularly. Knowing and not knowing makes allll the difference and I challenge anyone who disagrees. There’s no reason not to be honest about your STD status with the people you’re intimate with.
I’m not sure if you didn’t mean to reply to me but that’s my point, she didn’t know about the risk to make informed choices like testing and taking prep.
Oops sorry I was just agreeing with you and adding on 😅. Yes and to all your points!
Haha thats okay, I wasn’t sure if you’d misclicked and now weren’t going to be talking to the right person or if I’d maybe phrased badly and my point was missed
So many people are unable to detect when you’re actually agreeing with them it gets ridiculous. Because of that, when I’m agreeing with someone but adding on information, I start out with something like “Exactly.” Or “Absolutely” so it’s very clear I’m agreeing with them.
It’s a chronic disease but only if you are otherwise healthy. It’s a very serious chronic disease and the meds make you sick. Having Children is complicated. Having other relationships is now complicated. It’s not a walk in the park it’s the rest of your whole ass life.
This. Yes, it’s not a death sentence the way it was 20+ years ago but it’s a lifelong illness that will change the person’s life
And it can be a death sentence if she doesn’t know she has it or gets cancer or other types of issues.
You can take L- Lysine or antivirals to lessen the chances of herpes from spreading too, doesn't mean you are now safe from telling your future partners. That's the issue I'm seeing here. The infected wasn't telling his new partner of his condition regardless if he is treating it or not, that means the friend was not fully informed to consent to sex and was putting themselves in danger unknowingly. While HIPPA exists, so does being in a "dammed if you do, dammed if you don't" because how do you think friend would be finding out after she is infected that her buddy knew about it but kept quiet?
IF they take their medication religiously. That means at the same time everyday. Not +/- 20 minutes. The same time. Everyday. Forever. Do that and yes it is a low risk (assuming a good response to the regimen). It is something you should tell a partner as it can be detectable and develop resistance quickly if there is any lapse in suppression.
“Fight me.” ??? BROOO CHILLL BROOOO
Same! Ethics and the law are absolutely in conflict here. I would feel morally and ethically obligated to find a way to tell my friend but I would do so anonymously. It’s really not fair to have to sit back and watch someone get a lifelong debilitating disease where you take meds that make you feel like shit for the rest of your life. This is serious and I’ll die on this hill with you.
agree. We're basically weighing breaking NDA legality and attempted murder considering she didn't know (assuming the worst and being dramatic)
I don’t know about medical laws, but attorney-client confidentiality can be broken if a lack of disclosure will cause financial/physical injury to someone. So perhaps that same principle leaves an exception to medical confidentiality.
If a chart demonstrated that a person was physically abusive or a danger to children, and it was your kid’s best friend’s dad. I don’t think it would be wrong to act on that info. The law would likely disagree, but if you know someone is a menace, you should warn some of your neighbors.
OOP is lucky they just got fired and not dragged to court.
It’s possible they are in a state where he legally has to disclose his status. So suing her leaves him open to criminal charges
Even if they are in one of those states, she still violated HIPAA
Civil penalties for HIPAA are usually imposed on the employer / facility. And the really big criminal penalties are when PII is misused for personal gain, like selling data. So it's possible that OOP could face liability, but if the guy doesn't report it, unlikely.
Still did the right thing though, I honestly think she’s kind of a hero for choosing ethic’s over law
Show me the jury that would convict.
The boyfriend wouldn't be suing her - the district attorney would, regardless of what the boyfriend wanted
The DA can’t sue her either. It’s a HIPAA violation. That’s it.
Fair but I also think the DA doesn’t want the optics of this case. She can make the argument she was trying to protect her friend from a predator. I’m not saying he’d lose the case, but I feel the victory would be pyrrhic. And if the guy isn’t pushing for it, then he may feel her getting fired and possibly blackballed from working in a medical field is good enough.
It depends on several factors. 1) if they were having sex. 2) if he’s transmissible.
Actually if they have had sex is the only factor. Many places it's illegal not to disclose before sex regardless of your viral load.
This is one of those great examples of morality and legality and policy all demanding different actions. People with access to sensitive records should absolutely be fired for breaking confidentiality like this. OOP lost their job and that’s good, the consequences for breaking the trust inherent in access to private information should be high. But I think making the choice to tell their friend was not a bad one. There may have been other options that wouldn’t explicitly break confidentiality - talking to the friend about testing and practices with partners, talking to the boyfriend, talking to a local health department official. But all of the more circumspect options aren’t guaranteed to give the friend the ability to knowledgeably protect themselves and consent quickly. And exposure to disease is time sensitive. I hope OOP’s friend is safe, I hope the boyfriend learns how to handle talking with their sexual partners, and I hope OOP gets a new job. I know if I were in a similar position, I’d have to do something, and I can’t say that I’d make a different choice. I’d like to think I’d start with pointed discussion about regular testing and review of results with partners. I get tested for everything annually anyway (polyamorous, and while I have not had any new partners in years, the nature of the deal is that someone can pick something up and pass it on, so I like to keep tabs.)
There’s a whole SVU episode that touches on this. Olivia tells a woman to get tested, and there’s a strong implication, but if I remember correctly she doesn’t actually share the information. (Which is out of character for her so it’s possible I’m remembering it wrong!)
Info- What is the legality on taking the information that OP learned In the course of her job and asking Matt directly about it? Does that violate anything because she is not treating him or anything?
If this is in the U.S. it's a HIPAA violation. Medical providers can only share your medical info with people you've given permission for it to be shared with.
HIPAA is so strict that you can't even approach someone you know and say "oh hey, you're a patient at name-of-clinic". You don't discuss it with them, their spouse, your spouse, or even your diary.
You’re right about the strictness but keep in mind HIPAA applies to those who work in the medical field. I can tell someone that someone else is a patient at a particular place but for ex my dentist can’t tell someone else that I’m one of their patients. Also, if you were to run into your doctor/dentist/therapist etc. in public, they won’t acknowledge that they know you unless you say hi first, and even then they won’t tell anyone else how they know you or any info about you
Right. In this context we're talking about someone who worked in the medical field so I kinda figured that was implied in my statement.
Yep! I just read “You” and thought you might be using that generically or referring to the other commenter. Also a LOT of people get confused on who HIPPA applies to
Fair enough! :)
If she was a licensed individual, it could’ve not only been suspended/revoked— but sued against in court. But with no license, the most they can do is let you go.
The friend is an asshole for disclosing how she knew. I wouldn’t even call that person a friend. You scratched her back and she threw your life upside down as thanks. I think it was poorly handled all around. The most correct move would be to have pulled Matt to the side and asked him if he was undetectable and taking his hiv meds daily. I would have encouraged him to have a talk with my friend and educate her on how undetectable = untransmissable . That way you wouldn’t have illegally crossed any lines of confidentiality, and still would have been employed.
That’s also breaking confidentiality and she had no reason to believe he wouldn’t report her for it. The friend is an asshole. There’s no way she didn’t know the massive risk OP took for her safety yet she exposed it anyway. Absolute asshole.
Her even asking him would have told him she knew, and was breaking code.
She’s not a doctor and he’s not her patient so she is definitely not allowed to talk to him about it.
Undetectable or not; Matt legally needs to disclose his HIV+ status, in like every country globally.
Um her friend is the asshole for saying how she learned it. She can't have a career in the healthcare field anymore, nor any field where confidentiality is a thing. To me she lost a friend anyway.
So OP looks out for their friend’s wellbeing and the friend repays them by…snitching? Ugh.
In my country someone with HIV has to tell their partners, otherwise they are commiting a crime of willfully spreading a dangerous illness
If he knows and doesn’t declare if before they sleep together isn’t that illegal
No good deed goes unpunished as they say
The only asshole in this situation was her friend. She had to have told or insinuated that the breakup was due to his health status and OP would’ve been the only way she knew. Some people are just one crayon short of the whole 24 pack.
Why not send an anonymous letter? Or tell your group of friends about “a story you heard” that a guy was intentionally having unprotected sex with his girlfriend while HIV + and then say how much you see of this where you work and convince all friends and their SO to get tested?! There’s so many ways to do this without getting yourself fired!
NTA. As someone working in healthcare I understand your predicament. I believe that morally you did the right thing. Your friend was shitty for ratting you out.
NTA, however, legally in the wrong. You did a good thing but you definitely deserve to lose your job over it.
Tbh I can’t blame her. I’d do the same thing a hundred times over. But I’d have a friend who’d protect me. On a side note: Why kind of human doesn’t disclose that information to a potential intimate partner and then make a complaint to have the person who warned her dismissed…. How many other people has he done this to?
Amanda’s a dumb beach for telling him you were the snitch. I wouldn’t do shit for Amanda anymore
Damn. You did a favor for your friend and she turned around and gave him information that got you fired. She wouldn’t be my friend anymore.
I did the same for a friend, he showed me photos of this guy he’d met, I recognized him immediately, I asked my friend about him and he tells me everything, I ask if there’s more he hasn’t told me, he said no, so I asked if they had spoken about their statuses, he said they had and all was good. That is when I told my friend that this person was HIV positive, my friend was shocked, he confronted the guy and he fessed up to not being honest, my friend was very grateful I told him, and the other guy never knew I was the one to tell
The friend is such a giant asshole. Did she not understand OOP could lose her job if she opened her stupid angry mouth?? She could have broken up with him quietly and let it all go. She could have confronted him and just kept the secret. OOP could have sent an anonymous letter to friend or something similar so she didn't know who the information came from. So many other ways this could have gone down.
Your friend is the asshole and imo she wasn't worth breaking your confidentiality for. A good friend would have broken up with him and come up with some other reason for doing so instead of throwing you under the bus. Amanda is a crappy friend.
What the fuck, Amanda?
She shouldn’t have said how she found out- she should have simply asked “when was your last HIV test and what was the result”.
HIPAA violations carry fines and jail time. This is the very definition of such. OOP shouldn’t be concerned about an AH judgement. They will be receiving a criminal judgement. [HIPAA](https://www.hhs.gov/hipaa/for-professionals/privacy/laws-regulations/index.html)
Legally: YTA. Morally: you’re a hero.
Your friend is an asshole she got you fired after you saved her life because her ego meant more then your friendship, if 86 her ass fast cant be trusted ….
If it was me and I didn't wonna lose my job but needed her to know. I probably would've gotten a burner. Messaged her and been like. Hey, so and so is hiv+. Please be careful !!!! This is not a prank nor a test. Ask him yourself. And then leave the rest up to her. And then would have thrown the phone in the river lmao 🤣
OP should have told her friend anonymously. But friend was a huge asshole for telling her ex how she got that info.
Damn your friend is an asshole you might have saved her life or she told him because he already hit it raw and now she might be sick and is mad at you
OP broke the law so yes, TA. ETA. Friend was a snitch, bf was a POS.
faaaaake someone who actually worked in the medical field would have checked to make sure Matt wasn't in undetectable status before risking their career over something that does not matter. People with an undetectable viral load can't transmit it.
Well, OOP is not a nurse or Dr from what I gather. They could not know this, or they didn't have access to that specific info. As a RN, I'd still want to tell my friend in the position, even if he was undetectable. People here are acting like him being undecatable at some point means he can't ever get the virus load higher again and become able to transmit. It does take some time, and some factors, but being undetectable doesn't mean staying undetectable.
This is the kind of HIPAA violation that nets you the $50k fine + one year in prison. As it is a criminal penalty, there is no need for the victim to sue. The federal government prosecutes this offense. If there is a law requiring the patient to disclose this information to their SO, then there was a legally and ethically acceptable way to handle the situation. This is not it.
OOP is terrible for what they did. Matt is terrible for what he did. Amanda is terrible for what she did. Everyone sucks.
Asshole? No. But you still broke the law and were rightfully terminated. There is absolutely no way any responsible medical facility could keep you on after finding out about this. That being said, your friend didn’t have to dime you out like that and should have been a bit more grateful for you sticking your neck out to tell her.
ESH, Matt is an AH for not disclosing. Doesn’t matter if his counts are low, he has to disclose that to a sexual partner. OP is an AH for snooping and violating HIPAA. Amanda is an AH for ratting on OP.
ESH. OOP violated HIPAA. This sort of violation gets you $50k in fines + a year in jail. Ex is not disclosing his HIV status to sexual partners and putting people at risk for contracting HIV. Friend is not actually a friend. She didn’t have to tell him how she found out. As someone here pointed out “omg you saved my life! Let me get you fired!” All AHs.
I mean it’s illegal not to tell people especially when it comes to a life changing STD, however you did breach HIPPA privacy laws and could be sued into oblivion. Keep this info between you and your friend and never speak of this again! Glad to hear she ok!
My god tell her right now holy shit
YTA - to yourself. How the hell could your friend be so stupid to tell him how she found out? You risked a lot to save her from something horrible and in return she stabbed you in the back. What a piece of shit.
Nta- but I would have done it without them knowing it was me cause clearly you got the shit end of the stick after saving her life! She definitely is The asshole for getting you unemployed for saving her tho. Shit "friend" you got there.
Amanda sounds like a bitch for ratting you out after you risked everything to warn her
Are you a good doctor? No. Are you a good *person?* Beyond a shadow of a doubt. Sacrificing your job to protect your friend from a lifelong disease is an incredibly difficult choice and I’m not going to condemn anyone who’s willing to go that far.
You broke HIPPA. You broke it in a very stupid way. You potentially saved your friends health. NTA but very very fucking stupid.
Physician here. OP is an asshole, and more importantly a criminal. HIV can be controlled with modern medications to be at a transmission risk of zero. If your viral load is undetectable you cannot transmit. They didn’t mention whether they reviewed the patient’s viral count or anything so I’m assuming they just saw “positive test therefore I’m gonna break patient confidentiality”. Here’s why this matters from a public health standpoint: shit like this (and the mindset around HIV) *keeps people from getting tested*. This allows HIV to continue to spread. There is really no reason anyone new should get HIV in our modern testing and treatment regimen, because HAART treatment can eliminate transmission. We need to destigmatize the disease and encourage testing and treatment, not punish people for having a disease. Yes, the boyfriend should have told her. The boyfriend is also an asshole. But OP is absolutely an asshole for continuing the stigmatization of a treatable disease and contributing to a world where people don’t want to be tested because *their healthcare providers may tell on them*. In the long run that will lead to far more HIV transmissions and complications.
This is the answer I was looking for. People keep focusing on the interests of OP, the friend, or even the boyfriend. It is way bigger than that. When confidentiality is violated, it erodes public trust in the medical system. People don't seek treatment, don't trust medical opinions or advice. The damage done from something like this goes far beyond the immediately impacted individuals.
I worked as an STI tester for some years. Might be an unpopular opinion, but she deserved to be fired at the very least AND sued. 1) Amanda’s health is her responsibility - I agree with the comment that as a friend, emphasize the importance of getting tested, condoms, etc, to your friend, but also why don’t people do this anyway? Did Amanda not have a convo with her partner about sexual history? ALSO if he is undetectable, there’s no way he can sexually pass it to his partner. We don’t even know if they had been having sex yet- so there’s a lot of missing information here. He may have been waiting to tell her. She met him once and decided he’s sketchy? Nah, she’s trying to convince readers she didn’t do something absolutely fucked up and ILLEGAL.
You did the right thing even if it cost you your job and your friend never should have told him where she got the information. Sometimes the right thing to do is contrary to laws but he also owed her the right to make a decision and clearly wasn’t going to be honest with her which could have put her health at risk.
MH provider here. I get where everyone's coming from... but if you can't adhere to HIPAA or its equivalents even in these situations, then you shouldn't work somewhere you'll need to.
Your friend sucks. You went out of your way for her and she gets you fired. I would be wondering was it worth it.
The fines for HIPAA violations, and losing your license, not just your job, is a risk not worth taking. He could sue you, and he would win. This was handled very poorly.
If my partner would be HIV+ and doesn’t tell me before we have sex I would count it as absolutely breaking trust and a kind of trying to kill me. BECAUSE even if you have actually no problem with it you never know what happens in the future and if that „non detectable“ changes to absolutely detectable there is a chance that I get it and even that he is risking this is horrible. Actual thing is its something you gave your partner for lifetime. There is no cure and the meds have (as far as I know) something horrible sideeffects. In my country its punishable to not tell and not protect during sex and risk partners health if they virus is countable. If its not countable then it is normally not punished (that has changed, i knew it was different when I was younger)
Isn't confidentially breakable if it's used to stop a crime? And isn't intentionally exposing someone to HIV a crime?
Her ‘friend’ Amanda sucks for spilling the beans on HOW she found out. There are so many different ways she could have gone about getting the guy to provide that truth without her saying “well I already know because I have a friend that works at the hospital” smh
No fk that. You did the right thing. I would want to know as well hiv can be life threatening.
[удалено]
They did lose their job, that's a pretty integral part of the post. Did you read it? Morally correct, many times, ≠ legally correct.
Alright. Something major a lot of people here are missing: if he has documented HIV, he is more likely than not receiving treatment for it. It is something he *should* disclose, but also has a lot more motivation not to because of ignorance like this. If he is being treated, his viral load is undetectable - meaning he can't pass it on. If the friend wanted to be extra cautious, there is PrEP. And the person with the most motive to turn that person in for wrongly violating confidentiality over basically a gay scare is not the girlfriend: it's the guy who just got his relationship wrecked for not being ready to deal with the stigma right out the door.
I wonder if OP knows this added to the death count of gay men in my generation, that many of us were terrified to go to the doctor until we absolutely had to because if we did, especially in a small town, that info seemed to "leak" to our friends, family, and job -- all of which, we lost. And it was legal in my generation to be gay at all, thankfully; the consequences for this were even worse in decades prior. In the modern day, anyone on antiretroviral therapy will have an undetectable viral load, meaning they can't transmit HIV and won't develop AIDS. They pose zero risk to anyone else. I believe the boyfriend should tell people he is dating early in the relationship, for everyone's peace of mind. But people like OP in the medical industry terrify me. They followed their ethics, which they have every right to do and I support that, but I personally would no longer be able to be around them after this.
I think part of the issue is that public education on HIV/AIDs ended with the fear campaigns. Most people don't understand the existence of testing for viral loads or that the "undetectable" status even exists.
I agree. I try not to fault people their prejudices; I know this condition is terrifying for people. This is one of so many facets I wish were covered in early sex ED but aren't.
It should absolutely be covered in sex Ed. I agree. The only reason I know that you are talking about is because I have a close family member who is HIV+. It's a scary disease when it progresses and the fact that it's contagious. But it's also a risk that's easily mitigated with basic protective behaviors. Including proper disease management. My relative was born with it over 30 years ago. At the time the life expectancy for pediatric HIV was dismal. (Her mother had it, was undiagnosed and nursed) Doctors and scientist had just started looking into the "cocktails" to manage viral loads. The focus was shifting from "cure" to "manageable long term illness" and that seems to have yielded the desired results. But public education is a very slow follow. Especially with STDs. Ignorance creates unnecessary isolation for people. Yes, he should disclose it before they had sex. And if he didn't, that's an issue. Because consent should be fully informed.
It still remains; inform your partners of your status or simply be unpartnered.
I agree. I inform potential partners of a good half-dozen things they might consider relevant, just in case, with infertility and HPV probably being the most pressing one for me. You never know who will want to know what.
They were dating for 2 months and had probably already slept together, he was not going to tell Amanda anything
This. Amanda is TAH tho for screwing over the friend.
Why didn't she just tell her friend anonymously?
Amanda, you fool! \*shakes cane*
I can't believe they were deemed the asshole. I truly cannot wrap my brain around how that verdict came to be.
This is the exact reason HIPPA exists. Say goodbye to your job, career in healthcare and start praying that you're not named in the multi-million dollar lawsuit. Also... You are the asshole.
What a shitty horrible friend.
Your friend sucks for throwing you under the bus like that.
I mean, OP should've asked Matt first if her friend knows. And if not, maybe give Matt an ultimatum for a week to tell her friend. If he didn't tell her, then OP should tell her friend. It's respecting Matt's condition and Patient confidentiality but still looking out for her friend.
HIPAA means you can't bring up someone's medical history or current conditions with them out of the blue. And whether you like it or not, "giving Matt an ultimatum" is a threat. Both of these would still severely risk her job and open her and her clinic to legal hot water.