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Fourth Circuit: No Privacy Expectation Exists for Prisoner in Diagnosis and Treatment of HIV

by David M. Reutter

The Fourth Circuit Court of Appeals held that a prisoner does not have a “reasonable expectation of privacy” in his HIV status while in a prison medical unit. The court further held that individuals have no private right of action under the Health Insurance Portability and Accountability Act (HIPAA), 42 U.S.C. § 1320d.

The court’s May 27, 2021, opinion was issued in an appeal brought by Virginia prisoner Christopher N. Payne. His civil rights action concerned an event that occurred while he was in the medical unit at the Deep Meadow Correctional Center in 2018.

The basis for his action was that Dr. Jahal Taslimi approached Payne’s bed and told Payne he had “not take[n] [his] HIV medications” that day. Payne alleged the medical unit is an “open dorm” that allowed other staff, prisoners, and civilians within ear range to overhear Dr. Taslimi’s statement. He further alleged that some of those people “stopped talking and looked” at him. While Dr. Taslimi apologized, the damage was done—other staff and prisoners knew Payne was on HIV medication.

After exhausting his administrative grievances without relief, Payne sued in federal court alleging a Fourteenth Amendment privacy claim and a HIPAA violation. The district court dismissed the complaint for failure to state a claim. Payne appealed.

To evaluate the privacy claim, the Fourth Circuit said it must ask “(1) whether ‘a reasonable expectation of privacy’ in the information exists as to entitle a privacy protection” and, if so, (2) whether “a compelling governmental interest in disclosure outweighs the individual’s privacy interest.” It found that precedent established that prisoners have “no reasonable expectation of privacy” in prison. Precedent, however, has found such a privacy expectation in “bodily privacy and integrity.”

The court found that as a prisoner in a prison medical center, “Payne lacked a reasonable expectation of privacy in his HIV status and his compliance with his treatment plan.” It said that the location and type of information reduce any possible expectation of privacy that Payne may have had in the information.

The information that Payne had not taken his medication within the medical unit “was the most relevant place for such information to be shared and where it might be difficult to ensure others would not hear.” The information also dealt with a “communicable disease and whether he was taking his medication, which is especially relevant in a prison where disease can be spread rapidly (as seen by the COVID-19 pandemic),” the court wrote. “While HIV and its spread can be controlled by medicine, an inmate’s expectation of privacy in his diagnosis is still unreasonable during treatment because there remains a risk of transmission to prison workers and other inmates.”

Having found Payne had “no expectation of privacy in his HIV diagnosis and treatment,” the court turned to the HIPAA claim. HIPAA provides that “[a] person who knowingly… discloses individually identifiability health information to another person without authorization shall be fined, imprisoned, or both.” That act, however, delegates enforcement authority to the Secretary of the Department of Health and Human Services. It does not create a private right of action.

The district court’s order of dismissal was affirmed. See: Payne v. Taslimi, 998 F.3d 648 (4th Cir. 2021). 

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Related legal case

Payne v. Taslimi