“We document everything”: Interpretations of HIPAA and their impact on ASO staff charting practices in the context of HIV criminalization in the state of Georgia

Abstract Introduction: The growing professionalization of AIDS Service Organizations (ASO) and the criminalization of HIV nondisclosure have reshaped both ASO staff interactions with people living with HIV/AIDS (PLWHA) as well as ASO staff charting practices.   Methods: Building on a recent national research project in Canada, we conducted semi-structured interviews in February-April 2017 with N=12 ASO staff in Atlanta, Georgia to investigate their charting practices in the context of HIV criminalization.   Results: Our data showed no variation between professionalized and peer ASO staff in terms of charting practices, although the American participants reported being less protective about the content of their notes and less concerned about the risk their notes may pose in cases involving the criminal prosecution of an alleged HIV nondisclosure incident than was previously reported by their Canadian counterparts. In fact, we identified a false sense of security among American ASO staff stemming from their belief that the Health Insurance Portability and Accountability Act (HIPAA) would protect them from having to disclose their charting notes. Conclusions: We suggest that training and educational opportunities for both professionalized and peer ASO staff are needed to sensitize them to the implications of record-keeping on the prosecution of HIV nondisclosure.