To Tell and Not to Tell: The Illinois Law on HIV Disclosure
“In the name of protecting the health of all men and women, states should extend the privilege of HIV disclosure to any and all endangered third parties, not just spouses. As it stands, Illinois law uses marriage as a test of moral entitlement to public health protection in a way that works against the full value of disclosure privileges and that is ultimately inconsistent with a principled respect for all people at risk of HIV infection.”
So writes Timothy F. Murphy in the Perspective section of the September-October 2009 issue of The Hastings Center Report. As it currently stands, Illinois as other states do “gives physicians the privilege-but not the duty-to disclose an HIV infection to a patient’s spouse, even if they must override the patient’s wishes that they not do so.”
What Illinois lawmakers, however, did not extend was this privilege to a permanent couple who were not married or were simply sexual or needle-sharing partners.Thus the potential benefit, under these conditions, of informing, educating, diagnosing and initiating treatment if that other party was found to be HIV positive would be limited only to legally married couples.
What does this say about the Illinois lawmakers and their motivations to facilitate the treatment and prevention of spread of HIV and their apparently greater motivation to encourage a man to woman legal marital relationship?
Is this legislative action true public health or trying to extend a philosophical or religious bias? ..Maurice.
posted by Maurice Bernstein, M.D. @ 12:36:00 PM
3 comments
3 Comments:
They're very obviously imposing a religious or philosophical test to this law, as I can see no practical reason for informing marriage partners that wouldn't also apply to sexual partners or potential needle sharers. The only difference would be that the latter would be harder to identify and likely require the collaboration of the HIV patient, where marriages are registered and thus spouses are known to the state. I believe the potential risks of failure to disclose to partners exceeds the patient's right to privacy in this instance.
I don't mean to hijack this thread, but I have a similar situation where I have recently made the acquaintance of a young lady with HIV. She was severely injured in a motorcycle accident and has had multiple surgeries. She was denied treatment for her pain and was forced to turn to street drugs for relief, which is how she ended up with HIV. She is now off heroin and on a regular prescription of Oxycontin, which she has been on for years.
I've been thinking of inviting her to a fibromayalgia support group I go to, simply because she needs a lot of support right now. I am wondering if I have a duty to inform the other members that she has HIV. Of course, this dilemma can probably be resolved by asking her if it is okay if I tell the others she is HIV positive, but in the event she says no, what then? There's a lot of hugging and kissing going on at these meetings and I am too ignorant to know the risk of transmitting HIV from a kiss on the cheek. Medical science doesn't always have all the facts, and people should be free to determine how paranoid they want to be around a potentially fatal disease, however uninformed their suppositions.
Any advice would be appreciated.
From the United States Centers for Disease Control, here are the facts about HIV transmission from kissing and other routes. ..Maurice.
Kissing
Casual contact through closed-mouth or "social" kissing is not a risk for transmission of HIV. Because of the potential for contact with blood during "French" or open-mouth kissing, CDC recommends against engaging in this activity with a person known to be infected. However, the risk of acquiring HIV during open-mouth kissing is believed to be very low. CDC has investigated only one case of HIV infection that may be attributed to contact with blood during open-mouth kissing.
Biting
In 1997, CDC published findings from a state health department investigation of an incident that suggested blood-to-blood transmission of HIV by a human bite. There have been other reports in the medical literature in which HIV appeared to have been transmitted by a bite. Severe trauma with extensive tissue tearing and damage and presence of blood were reported in each of these instances. Biting is not a common way of transmitting HIV. In fact, there are numerous reports of bites that did not result in HIV infection.
Saliva, Tears, and Sweat
HIV has been found in saliva and tears in very low quantities from some AIDS patients. It is important to understand that finding a small amount of HIV in a body fluid does not necessarily mean that HIV can be transmitted by that body fluid. HIV has not been recovered from the sweat of HIV-infected persons. Contact with saliva, tears, or sweat has never been shown to result in transmission of HIV.
Thanks a lot, Dr. Bernstein. Greatly appreciate the info on HIV transmission.
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