Partner Notification: The Powers of Government Agencies

• Pages: 20-22

Contenidos

• The Issue.
• Legal and Policy Considerations.
• Practice Examples.
• References.

Page 20

The Issue

In partner notification (or contact tracing), public health agencies within the government take responsibility for locating and notifying partners of HIV-infected individuals that they may have been exposed to HIV infection. Typically, the health department obtains information voluntarily from an HIV-infected person about their past and present sexual and needle-sharing partners. Health officials then use this information to trace these contacts and to notify them of their potential exposure to HIV. This process can then be repeated with new contacts. The public health justification for contact tracing differs from other types of partner notification. Rather than invoking the patient's right to know or the practitioner's duty to warn, in this context partner notification is based upon practical efforts by the public health department to prevent further infections by interrupting the chain of HIV transmission, and getting more people into treatment.

Legal and Policy Considerations

Most partner notification schemes first encourage HIV-infected patients themselves to notify their partners about their HIV status and then impose partner notification responsibility on the patient's physician or counselor if the patient is unable or unwilling to follow through with notification (see Topics 1.4, 1.5). Contact tracing often supplements these efforts or allows for some of the same results in situations in which neither of these other approaches is feasible. Some laws and policies allow physicians to refer their patients' cases to medical officers in the health department, who may have more resources than the physician to engage in partner notification.

Confidentiality is of paramount importance in the contact tracing process. Laws and policies frequently demand that public health officials take significant precautions to protect the identity of the patient who has provided contacts' information. In practice, maintaining confidentiality may be difficult as the notified contact may be able to identify the HIV-infected index patient despite the determined efforts of public health officials to maintain confidentiality. Regardless, efforts to maintain confidentiality encourage voluntary participation in partner notification efforts and reduce the likelihood of stigma, discrimination, violence, and other negative impacts associated with the...