Respond to post below: Human immunodeficiency virus (HIV) is currently a chronic

Respond to post below:
Human immunodeficiency virus (HIV) is currently a chronic manageable health condition. HIV was once a “death sentence” disease, but with the advancement of antiretroviral therapies, the disease burden has declined in the United States of America since 2019 (Sauermilch, 2022). HIV incidence is still high, with the gay community accounting for 70% of cases in 2019 (Centers for Disease Control and Prevention [CDC], 2022). Sauermilch et al. (2022) noted that for HIV seropositive individuals who comply with antiretroviral therapy, the virus could be suppressed to zero transmission risks to a seronegative individual even without the use of barrier protection.
HIV disclosure is still a contentious topic, as the effects of disclosing such information could have a negative outcome for an individual. In my opinion, however, individuals should disclose their HIV status to their partners, especially when they engage in active sexual relations, which is one-way people get infected with the virus. In a study to examine the attitude of sexual and gender minority men towards HIV-positive status disclosure, the majority of the participants believed that a disclosure to an intimate partner was necessary even with an undetectable virus; they contended that disclosures serve as a means of education the sex partners, transparency, and for safety (Sauermilch, 2022). Disclosing one’s HIV status is critical to keeping both partners healthy and is a step towards positive living and taking a proactive role in stopping the spread of the virus and treatment. Some states in the United States criminalize HIV exposure; hence people with knowledge of their HIV status must disclose their status to their sex partners (CDC, 2022). In addition, I think it is reasonable for an individual to carefully self-disclose HIV-positive status to her/his medical provider for early treatment, to prevent population spread and aid in public health disease trending reports.
Though state laws vary wildly, and for the provider’s mandatory disclosures, healthcare providers have no right or obligation to disclose a patient’s health status, including HIV. The Health Insurance Portability and Accountability Act (HIPAA) privacy rule protects a patient’s privacy and confidentiality, and health professionals are among the covered entities in the HIPAA regulations (Health and Human Services.gov [HHS], 2023). Therefore, healthcare providers are not allowed to disclose personal health information (PHI) without the patient’s consent, as they risk facing penalties associated with HIPAA privacy rule violations. The individual has the right to deny a disclosure, and healthcare professionals are not allowed to share sensitive health information unless on the ground for medical management. When I checked my home state, there is a duty to warn (notification of the person who is very likely to contract the disease from a seropositive individual), a provider encourages the individual to notify the sexual partner or obtain permission to notify appropriate sexual partner, or the local health department can step in to assist the individual. The Provider is not obligated to disclose HIV-positive status without a duly signed disclosure by the patient. Besides the penalties, mandatory Provider disclosure may have serious social consequences, such as employment and health insurance discrimination, and may even hinder the prevention effort (Sauermilch, 2022).
An ethical dilemma arises when the question of confidentiality arises, especially regarding public health and individual rights to medical confidentiality. Patient individual confidentiality is a right whose protection is under the concepts of beneficence, nonmaleficence, justice, patient autonomy, and creating a patient-provider fiduciary relationship (Olejarczyk & Young, 2022). Thus, public health concerns do not prevail over individual rights to medical confidentiality as it would go against medical care’s ethical principles. The individual has the right to deny a disclosure, and healthcare professionals are not allowed to share sensitive health information unless on disease management or circumstances stipulated by law. However, the Covid-19 pandemic significantly challenged this concept considering how fast the disease could spread and its adverse implications on public health, the stigma associated with the disease, and the misinformation that had widely spread about it (McGuire et al., 2020). Concerning infectious diseases, population health is critical. A balanced approach to privacy and protecting confidential information is required, whereas reporting to authority is vital for treatment, prevention, surveillance, and allocation of resources.
References
CCenters for Disease Control and Prevention (2022, October 24). HIV and STD Criminalization Laws. https://www.cdc.gov/hiv/policies/law/states/exposure.html#:~:text=HIV%20and%20STD%20Criminalization%20Laws%202022&text=In%2010%20states%2C%20laws%20require,a%20matter%20of%20state%20law.
MMcGuire, A. L., Aulisio, M. P., Davis, F. D., Erwin, C., Harter, T. D., Jagsi, R., & COVID-19 Task Force of the Association of Bioethics Program Directors (ABPD). (2020). Ethical challenges arising in the COVID-19 pandemic: An overview from the Association of Bioethics Program Directors (ABPD) task force. The American Journal of Bioethics, 20(7), 15–27.
OlOejarczyk, J. P., & Young, M. (2022). Patient rights and ethics. National Library of Medicine. https://www.ncbi.nlm.nih.gov/books/NBK538279/
SaSauermilch, D., Siegel, K., Hoppe, T., Roth, G., & Meunier, É. (2022). Attitudes toward HIV-positive status disclosure among U=U-aware sexual and gender minority individuals in the USA: A consensual qualitative research approach. Sexuality Research and Social Policy. https://doi.org/10.1007/s13178-022-00710-1
U.S. U.S. Department of Health and Human Services: Civil rights (2023). Protecting the civil rights and health information privacy rights of people living with HIV/AIDS. https://www.hhs.gov/civil-rights/for-individuals/special-topics/hiv/index.html