[Aids and the right to privacy]

Fear of AIDS exceeds by far the apprehension concerning any other disease: it is mostly irrational, and is driven by a distorted perception of the disease as well as the stigmatization of patients. A major question faced by healthcare systems worldwide concerns the relation between the patients' responsibility to prevent spreading of the virus and the responsibility of the healthcare authorities on this matter. Early HIV detection and treatment, together with proper patients' education, reduce the odds of further infections. Therefore, HIV patients who choose to refrain from partner notification present a significant challenge to the medical staff, as they may rely on human rights and patients' rights principles. This paper deals with dilemmas concerning nonconsensual HIV reporting. The authors advocate a distinction between two types of sexual relationships: whereas in casual relations, both partners share (non-equivalent) responsibility for their safety, in a monogamous and stable relationship, the infected partner is responsible both ethically and legally, for partner notification. Nonconsensual notification is ethically acceptable in the latter type of relationships rather than in the former. Such notification should be as discrete as possible and patients' protection against potential violence and discrimination must be safeguarded. Prior to the notification, the HIV patient should be provided with advance notice. According to the Israeli Patients' Rights Law, such notification is subject to the authorization of a statutory ethics committee. The authors additionally contend that the adherence to the human rights of HIV patients promotes public health interests of preventing the spread of AIDS.