MSc (Med), Bioethics and Health Law, Steve Biko Centre for Bioethics, Faculty of Health Sciences, University of the Witwatersrand, 2009 / Disclosure of HIV status has been considered an important public health issue for some 20
years. Yet the ethical issues surrounding the disclosure of positive HIV status have not
been examined comprehensively. This report examines the ethics behind the disclosure of
HIV-positive status primarily or individuals to their sex partners, and for health care
practitioners to a patient’s sex partner when the patient is unwilling to disclose. Relevant
rights and ethical principles are analysed, including the rights to: self-preservation; privacy
and confidentiality; and the bioethical principles of respect for autonomy, beneficence,
non-maleficence, and justice. Historic and contemporary individual rights that people
living with HIV (PLHIV) have regarding disclosure are emphasised, especially in adverse
circumstances, where ethics can support non-disclosure based on the right to selfpreservation.
Rights declarations and current disclosure guidelines for health care
practitioners from several international and South Africa medical organisations also are
reviewed. Of key importance to disclosure decisions are the specific situations of
individuals in climates rife with stigma toward, and discrimination against, PLHIV,
existing more or less worldwide. The potential negative impacts of disclosure are the basis
for disclosure decisions of PLHIV. Research study results show that the negative impacts
of disclosure can be severe for individuals, ranging from divorce or abandonment to
community ostracism and even to murder. Relevant current theories of social justice
related to HIV disclosure also are discussed. A conclusion is reached that, by decreasing
stigma and discrimination against PLHIV and protecting individual rights related to HIV
disclosure, prevention behaviours will be practised more widely, including ‘positive
prevention’ by PLHIV and higher rates of disclosure. The eventual result will be the longterm
public health goal of decreased spread of HIV.
| Identifer | oai:union.ndltd.org:netd.ac.za/oai:union.ndltd.org:wits/oai:wiredspace.wits.ac.za:10539/7995 |
| Date | 16 April 2010 |
| Creators | O'Grady, Mary |
| Source Sets | South African National ETD Portal |
| Language | English |
| Detected Language | English |
| Type | Thesis |
| Format | application/pdf |
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