As conversational LLMs become deeply embedded in daily life, users frequently disclose sensitive personal health information during routine interactions. We present a large-scale computational audit analyzing 179,057 conversations across India, Nigeria, Brazil, and Pakistan (N = 1,057) to evaluate personal health disclosures and background memory synthesis in ChatGPT. We find that 21.31% of audited conversations contain personal health data, with 3.62% posing high-to-extreme privacy risks involving stigmatized conditions, direct identifiers, and precise locations. When evaluating the memory entries of ChatGPT, we uncover a stark disconnect between corporate framing and system behavior: over 95% of profile entries are implicitly extracted without explicit user prompts or consent. Furthermore, background memory synthesis selectively condenses temporary, symptom-level disclosures into permanent diagnostic traits, stripping contextual integrity and amplifying re-identification risks. We conclude with sociotechnical design guidelines to restore user agency and consent-driven boundaries in stateful AI systems.

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