Disclosure at work. Whether I want to or not.

[libvet]

So, here's the situation.

For the last few years I have been working in a pharmacy.  I have managed to keep my HIV status private because I have been using a third-party pharmacy to fill my HIV meds.

Got a call this morning from third-party pharmacy saying that I am likely to have to use my local pharmacy which is where I work.   Due to this turn of events, there is absolutely no way I am going to be able to keep my HIV status from my co-workers.

I am not quite sure how to handle forcible disclosure.   Even with HIPAA, tongues will wag.  The first time someone brings up my profile to enter or verify my prescription at work, I am forcibly outed.

So, that's that. I have managed for 19 years to build a wall of privacy between my HIV status and my employment. 

Any good advice? 

[leatherman]

how is the cost of your meds covered? through insurance, adap, or other? If you need to fill from a "local pharmacy" you should be able to pick whatever pharmacy you consider "local" to fill your scripts (as long as that pharmacy is "in your network"). "local" doesn't actually mean a pharmacy close to you but a pharmacy that doesn't refill by mail or through a speciality pharmacy

[Ptrk3]

I agree with the sentiments of leatherman, libvet.  Your situation does not seem right to me (the insurance position that you perceive will force you to disclose).  I can't believe that simply because of your profession, and your unique situation, that a fair implementation of HIPAA would require you to divulge your status to professional peers with whom you work.  That type of situation is what HIPAA seeks to avoid for any reason (why should your peers know that another peer has been prescribed insulin or anti-depressants, not to mention HIV or Hep C).

There must be a solution to your predicament in order that your insurance complies with the spirit of HIPAA.

As leatherman suggests, find out exactly what local means and/or pursue a mail-order option, if available.  In my view, the insurance company really needs to work with you on this in order to maintain your privacy.

[harleymc]

The wost that comes in your imagined what if scenario is that a health professional who is governed by HIPAA becomes aware of one of your health conditions.

Do your colleagues have a history of breaching patient confidentiality? If why have you covered these breaches up.

If they don't breach patient confidentiality then the scenario is no different from someone who works I. A postal pharmacy who fills your orders.

Clearly your doctor, a nurse, a receptionist already know why are you so distrustful of  your colleagues?

Don't freak out get some counseling.

[kentfrat1783]

I think I understand what you are talking about as I fear the same thing at my work.
 I work in HR and on the insurance committee and we are looking at the high-cost Rx's right now.  We don't know who the Rx's belong too but being a business under 100 employees you could potentially piece things together. 

You aren't worried that your co-workers (employees) are going to purposely look at your information and go against HIPPA.  It is just part of their job to verify orders, confirm that the appropriate meds are on hand to verify nothing was stolen or lost.

I would also assume that it isn't legal for you to fill your own Rx order (you would know more about that then I do).  So if you aren't allowed to fill your own order then another of your co-workers (employees) would need to do it.  And that would, in turn, let them know more about your medical history. 

I'm not saying that you would want to lie but could you put a spin on it and say you are taking it for PREP?  Then again do you think they would care?  I am sure it is so much you see as a pharmacist that if you don't make a fuss maybe they won't either. 

But I agree with others on here I'm sure you aren't the only pharmacy in town so you could also find another one.  But the local hospital in town if you have the insurance through them the only option is to use their pharmacy if not the Rx won't be covered.  (Doesn't seem fair)

Just look at your options and talk with your insurance carrier.  Also, talk with your doctor and nurses as they might have a recommendation on pharmacies or get you in contact with a caseworker to help you. 

Just wishing you the best,
Kenneth

[MadDog125]

Why would if have to be local?  Can't you take your script anywhere? I don't get a choice on local pickup.  Mine come by mail order.  Except for right after DX.  The ID ordered a month supply sent quick to the Pharmacy i picked.  So i went to the next town over.  Can't your ID do something similar?