Disclosure of human immunodeficiency virus status in healthcare settings: ethical concerns

As knowledge of human immunodeficiency virus (HIV) disease increases, society's attitudes toward disclosure of seropositivity are reverting to a traditional public health approach. Both patients and healthcare professionals fear HIV infection (although the risks of transmission in healthcare are small), and broadly support disclosure. In this article, the disclosure issue is examined within a framework of the ethical principles of autonomy, nonmaleficence, beneficence, and justice, which suggests that patients and healthcare professionals should be required to disclose known seropositivity before exposure-prone procedures are performed. Because of the risk of stigmatization, renewed effort to prevent unwarranted disclosure by healthcare professionals also is required.