Australia: New policy suggests doctors will report ‘risky’ HIV-positive patients

‘Risky’ HIV carriers to be reported

by Julia Medew and Carol Nader

July 25, 2007

CIVIL libertarians have attacked a decision by Australia’s health ministers to introduce mandatory reporting by doctors of “risky” HIV patients to state health authorities.

The nation’s health ministers decided on the policy change yesterday at a meeting in Sydney.

Victorian Health Minister Bronwyn Pike said doctors would only have to report HIV-positive people they believed had deliberately infected others or may intentionally infect others with the virus.

“We have a very strong public health prevention approach to HIV and we have protocols for dealing with people who are engaged in reckless behaviour, but this provision is for that very small group of people who wilfully and intentionally infect others,” she said.

“It’s very important to affirm that this is not about mandatory reporting of everyone who has HIV, or changing the overall public health approach, but it is recognition that there is a very small group of people who we must know about. Mandating doctors to tell the Health Department is one way of us being able to have a good public safety approach.”

Ms Pike said the issue had become of concern more recently, and while there were protocols in place with the police “which would probably pick up this group of people anyway”, the initiative added an extra layer of reporting “to make sure nobody goes under the radar”.

The announcement comes while three Victorian men are before courts on charges of recklessly or intentionally infecting others with the virus.

It also follows Ms Pike’s admission in April that the Victorian Department of Human Services bungled its management of Michael John Neal — a Melbourne man accused of infecting two men and attempting to infect another 14 men while he was known to the authorities.

Australian Federation of AIDS Organisations executive director Don Baxter and the Federal Government’s chief adviser on HIV, Michael Wooldridge, welcomed the national consistency yesterday.

“We would agree with that approach where it’s very clear to the doctor that the person is intending to infect somebody else,” Mr Baxter said.

But Robert Niemann, a spokesman for Liberty Victoria, criticised the move as a “major and obvious attack” on patient-doctor confidentiality.

He said the decision could discourage people from taking HIV tests and communicating openly with their doctors, which could in turn affect doctors’ ability to control and treat the virus.

“Any doctor asking a patient whether they are having unprotected sex should, in my opinion, warn the patients that they could be reported to the Government,” Mr Niemann said.

Dr Jonathan Anderson, a Carlton doctor who treats HIV-positive patients, said clinicians already understood the need to balance their prime responsibility for patient confidentiality with wider public health.

“I don’t believe there’s been any problems with the way doctors have reported cases to health departments, rather there have been problems within health departments,” he said.