Should HIV patients hide their status to their spouses?
Transparency in relationships is one of the most critical, though perhaps under-appreciated, components in developing a healthy connection. The lack of emphasis on transparency in marriage is most likely due to a misunderstanding of what "transparency" entails. People have different interpretations of what transparency is, but it is all about being honest and upfront about your own issues, as well as providing your partner the freedom to select what they want for themselves.
In Africa, a high number of HIV infections occur inside stable partnerships, either as a result of earlier infection of one of the partners or as a result of adultery. In some African nations, at least two-thirds of couples with at least one HIV-positive spouse were HIV serodiscordant. A couple-centred approach to HIV counselling and testing would enhance communication about HIV status and the adoption of preventative behaviours within couples. Despite promising results, couple-oriented programs have not been widely adopted.
In Sub-Saharan Africa, the disclosure of HIV sero-positive results among HIV-discordant couples is often low. The disclosure of HIV-positive findings in discordant couples utilising facilitated couple counselling is high in Uganda, but it needs a step-by-step procedure of sensitisation and assent by the infected spouse.
About half of HIV-positive persons in stable partnerships have an HIV-negative spouse or family member, and the majority are in a serodiscordant relationship. These proportions have been found in both the general population and among women and their partners attending prenatal clinics.
Informing or alerting HIV-positive patients' sexual partners about their serostatus might help to reduce the spread of HIV/AIDS since sexual partners can avoid having unprotected sex with infected people, however this will jeopardise patient confidentiality.
Doctors are thus faced with a quandary as to which should take precedence: patients' right to privacy and confidentiality or the need of restricting the spread of the epidemic to society. Most medical regulatory authorities do not take firm stances on the topic, leaving the decision to individual practitioners.
In HIV testing, it is critical that a negative pair understands the status of his or her positive spouse, but it is not the health care provider's responsibility to reveal someone's result to another person without his or her agreement. It is critical to receive proper advice.