Partner Notification: The Responsibility of the Patient

• Pages: 13-15

Contenidos

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

Page 13

The Issue

Partner notification offers a chance to increase the number of people who will seek testing and counseling for HIV, and to get more people into treatment. The partner notification process encourages (and sometimes obligates) a person to disclose his or her HIV status to sex and/or needle-sharing partners or to take efforts to reasonably protect partners from avoidable health risks. Partner notification has become a common practice around the world in HIV prevention efforts, but has remained controversial. Public health professionals justify partner notification programs as a method of prevention and access to treatment. In many cases there appears to be an ethical duty to disclose one's HIV status to partners who may be at risk of infection. This duty is grounded in the obligation to do no harm to others and the concept of a partner's "right to know" about the risks they may face. In this respect, the duty to disclose is grounded in the need to prevent further infection. Nevertheless, whether infected persons have the responsibility to inform their partners of their HIV status continues to engender debate. Some AIDS advocates argue that if a person infected with HIV consistently uses safer sex practices (using a condom), he or she may not always be obliged to inform.

Legal and Policy Considerations

In many countries, the HIV-positive index patient is primarily responsible for informing his or her sexual or needle-sharing contacts that they may have been exposed to HIV. Laws and policies have implemented this duty in the form of programs that require, or alternatively encourage on a voluntary basis, partner notification by HIV-infected individuals. In many cases, the government or other public entities will provide both the patient and partners with access to counseling, testing, and if necessary and available, treatment. Most countries that authorize partner notification prefer voluntary partner notification to other, more coercive, approaches. The UNAIDS and OHCHR International Guidelines on HIV/AIDS and Human Rights also adopt this approach. Likewise, UNAIDS and WHO encourage voluntary disclosure between partners and the provision of professional counseling for HIV-infected clients and their partners. Other approaches, less common, impose an affirmative duty on HIV-infected individuals to inform their partner of their HIV...