Routine third party disclosure of HIV results to identifiable sexual partners in Sub-Saharan Africa
The challenges of dealing with disclosure of HIV status cause frustration to health care providers and counselors. This frustration follows from the already known high risk to the third party on one hand and our ethical obligation to “respect persons” in terms of privacy and confidentiality on the other side. Given the stubbornly low rates of voluntary disclosure (partner notification) among couples, however, it is quite tempting to suggest a paradigm of routine third party disclosure to identifiable sexual partners by health care providers. This might be the lesser of the two evils and might give better public health outcomes in the fight against HIV/AIDS in Sub-Saharan Africa.
KeywordsThird-party disclosure HIV status Identifiable sexual partners Confidentiality Sub-Saharan Africa
- 1.Stuart, Rennie, et al. 2006. Desperately seeking targets: the ethics of routine HIV testing in low-income countries. Bulletin for the World Health Organization 84: 52–57.Google Scholar
- 2.Botswana Networld on Ethics, Law, HIV/AIDS (BONELA). 2003. Event report: Routine versus compulsory test. http://www.bonela.co.bw/Reports/SeminarReport. Accessed 27 Nov 2005.
- 3.Beauchamp, T., and J. Childress. 1994. Principles of biomedical ethics. New York: Oxford University Press.Google Scholar
- 4.Soyinka, F. 2007. Phyiscian’s dilemma in the management of HIV/AIDS in Africa. IN CODESRIA, CLNS, ORSTOM international symposium of social science and AIDS in Africa. www.codesria.org/links/publications/aids/soyinka. Accessed 6 Nov 2007.
- 5.Nwanma, Vincent. 2005. In AIDS fight, men make a difference (Campaigns in Africa seek to change male behavior): Silence no more, Africa fights AIDS. New York, Africa Renewal, U.N. Department of Public Information.Google Scholar
- 6.World Health Organization. 2003. The right to know: New approaches to HIV testing and counseling. http://www.who.int/hiv/ev. Accessed 3 Oct 2008.
- 7.Kirungi, Fred. 2005. Uganda beating back AIDS, leadership, education and openness are keys to progress: Silence no more, Africa fights AIDS. New York: Africa Renewal, U.N. Department of Public information.Google Scholar
- 8.Malawi Law Commission. (2007). Report of the Malawi Law Commission on the development of HIV and AIDS legislation. Google Scholar
- 9.The Malawi National HIV/AIDS Policy. June (2003). http://www.ilo.org/public/english/protection/trav/aids/laws/malawi1.pdf. Accessed 6 Nov 2007.
- 10.Kadida, Jillo. 2005. Daily Nation, Nairobi Kenya, 14 July.Google Scholar
- 11.Office of the United Nations High Commissioner for Human Rights and the Joint United Nations Programme on HIV/AIDS. 2007. International Guidelines on HIV/AIDS and Human Rights. http://data.unaids.org/Publications/IRC-pub07/jc1252-internguidelines_en.pdf. Accessed 6 Nov 2007.
- 13.Council for International Organizations of Medical Sciences. 2002. International ethical guidelines for biomedical research involving human subjects. Geneva.Google Scholar
- 14.Elliot, Richard, and Mirriam Maluwa. 2002. Criminal Law, public health and HIV transmission: A policy options paper prepared for a joint United Nations Programme on HIV/AIDS. http://data.unaids.org/publications/IRC-pub02/JC733-CriminalLaw_en.pdf. Accessed 3 Oct 2008.
- 15.Susan, Allen, et al. 2003. Sexual behavior of HIV discordant couples after HIV counseling and testing. Official Journal of the International Aids Society 17 (5): 733–740.Google Scholar