Non-disclosure of HIV status to intimate sexual partners : ethical and medico-legal issues

Abstract

The non-disclosure of HIV status to an intimate sexual partner creates an ethical dilemma in terms of the healthcare practitioner’s duty to respect the patient’s autonomy (right to privacy and confidentiality) and the duty to promote public health (duty to inform individuals of possible health risks). The study seeks to asses if non-disclosure creates legal liability on the part of the non-disclosing partner and ethical and medico-legal liability for the healthcare professional involved (if the sexual partner is known). This is a descriptive desk-top study, analysing 14 studies with a study population of 7428 participants in respect of the extent of non-disclosure of HIV status to sexual partners. The overall rate of non-disclosure is a range of 15 to 49 per cent. This study concludes that disclosure by a health worker of a patient’s HIV status to a sexual partner is unjustified, except in the case of a clear intent by the patient to transmit HIV. It recommends that, in these circumstances, ethical and legal liability should not attach to the non-disclosing partner or to the healthcare provider.