Privacy Worry May Keep HIV Patients From Therapy

NEW YORK (Reuters Health) - HIV -infected patients are often concerned about the confidentiality of their HIV-positive status. In fact, some patients are so worried that they will actually forgo treatment to prevent the release of this information, according to a report published in the August issue of AIDS Care.

Dr. Kathryn Whetten-Goldstein and colleagues from Duke University, Durham, North Carolina, studied the confidentiality issues of 15 HIV-infected patients from rural North Carolina locations. Each participated in focus groups designed to explore their attitudes toward, and experiences with, breaches in confidentiality.

``The fear of a breach in confidentiality is definitely affecting the care that HIV-infected patients receive,'' Whetten-Goldstein told Reuters Health. ``Most study patients had experienced or knew someone who had experienced a breach in confidentiality,'' she stated.

``Two types of breaches occurred,'' Whetten-Goldstein noted. ''The first was a more obvious type of breach. One example was a nurse who told her child that her patient was HIV-positive out of concern that her child would play with the patient's child.

``The other type of breach was more subtle, one that providers might not consider breaches,'' Whetten-Goldstein explained. ``This type of breach involves providers talking about a patient's HIV status without the patient's knowledge of the interaction.

``The law allows the sharing of information between providers within the same institution,'' but patient consent must be obtained before providers at different institutions can share information, she pointed out.

``Patients in the study wanted providers to tell them when they are going to share information with other providers and why it is being done,'' Whetten-Goldstein said. ``They also felt that providers should be punished when a breach occurs.

``However, because patients are often reluctant to seek legal action which may further expose their status, they felt that the system should regulate itself,'' she added.

SOURCE: AIDS Care 2001;13:457-466.