Protecting the right to personal health information privacy in Nicaragua

Context: In an era of genetic testing and other cutting-edge diagnostic and medical capabilities, a patient's right to privacy has been at the forefront of the U.S.'s consciousness. In Nicaragua, however, this fundamental human right is frequently denied the attention that it merits. Nicaragua has a combined unemployment and under-employment rate of nearly 46%. The surfeit of job applicants relative to the number of jobs available has created a situation that facilitates job discrimination based on employees' health status. Job applicants are often asked to provide potential employers with health-related documentation, such as the results of a urinalysis, HIV/AIDS test, and/or pregnancy test, even when the information is not germane to the applicants' abilities to perform the job in a safe manner.

Objective/Methods: The objective of this study is to review codified Nicaraguan health, employment, and human rights laws and regulations in order to identify what protections, if any, exist to prevent the exploitation of workers and to identify areas of improvement to ensure workers' rights.

Findings: While the Nicaraguan state claims that medical confidentiality is a protected right, victims in fact have little recourse to redress their grievances without adequate avenues in place. Furthermore, punishments for violators are rarely specified in the regulations. Nicaraguan Law 238 regarding HIV/AIDS is the strongest, most progressive piece of legislation related to this topic. It can serve as a template for crafting additional protections that more broadly protect medical confidentiality.