Dear Center for Phlebotomy Education:

I run a phlebotomy school and have a student who is HIV-positive. I know there are HIPAA rules that prevent the sharing of health information with those who don't need to know, but I'm not sure it applies to schools. Am I obligated to make sure the other students are aware of her HIV status? The other question is whether or not this person would be employable in phlebotomy. I don't want for her to go through all this training and expense only to be someone nobody would hire. When we are aware of a trainee's HIV status, what should we do?

My response:

There's a lot to unpack here, but I'm glad you asked.

Generally, student health information is not subject to HIPAA regulations. However, it may be covered under FERPA regulations (Family Educational Rights and Privacy Act). The U.S. Department of Health and the Department of Education have an informative document that distinguishes between the two. Regardless of the applicable regulation, it is my opinion the privacy of the health information of all students should be respected and kept confidential. 

There's a far greater risk a student will become infected from an HIV+ patient than a patient become infected by an HIV+ phlebotomist. So I don't think the risk should cause any concern. HIV is far less transmissible than Hep C (0.3% versus 30%). In fact, most patients with Hep C don't even know they have it since it can be dormant for decades before attacking the liver. That's why it's important for you to drive home standard precautions and make sure your students treat every patient as potentially infectious.

Your question about whether or not an HIV+ student is employable in your area is a far different question. Be aware there are a lot of misperceptions about this. You should call several of the larger employers in your area and survey them to see if there's any hesitance to hire HIV+ phlebotomists. There shouldn't be, but you should check.