• Certain infectious diseases are notifiable under the Public Health Act (Food poisoning, Leprosy, TB etc)
• However HIV & AIDS are not notifiable (AIDS (Control) Act 1987), but total numbers of HIV positive patients should be reproted to the Secretary of State from each Strategic Health Authority

Offences Against the Person Act 1861 :-

• Technically if the wife becomes infected with the HIV virus with the husband aware that he carries it and not informing of her risks, he will be committing battery.
• Assault is covered by this act with battery being enshrined in common law.

• In this case, the doctor can (and should) break confidentiality in order to protect the interests of the patient's wife, given that he is openly telling the doctor that he is having unprotected intercourse with her.
• However, should the case be that he is not having intercourse with her, and poses no threat to others, then doctors should maintain patient confidentiality.
• HIV is still a highly stigmatising diagnosis, and the between trust between the doctor and patient is of utmost importance here.
• Informed consent: We assume that if the "at risk" individual (i.e. wife) was informed, she would choose not to be exposed to infection. i.e. if an HIV positive surgeon refuses to disclose the status of his infection to anyone but his GP, his GP has a "duty of care" to breach his confidence and to inform the appropriate body. This is because patients who are operated on if not told of the surgeon's HIV status cannot give informed consent.
• Duties to patient, duties to others: Both to the GP's own patient as well as the partner of the GP's patient.

• When to breach confidentiality and how to do it should be taken on a case-by-case basis - with the doctor being more or less confident that the partner will be safe.
• The doctor should disclose the HIV status only when there is a serious and identifiable risk to a specific individual who, if not so informed would be exposed to infection.
• Judgement about what is deemed serious harm must also be considered. HIV although severe is not immediately life-threatening and with use of new drugs a patient can survive for decades. In contrast diseases like Chlamydia which can cause pelvic inflammatory disease and possibly infertility aren't deemed as causing serious harm.
• One problem that doctors may face especially as GUM clinicians is that patients may come in under a false name, and without the ability to track down an uncooperative patient; the clinician might squander their only opportunity of protecting further individuals with whom the patient may have sexual contact.
• The doctor at the end of the day needs to demonstrate that breaking confidentiality was not just morally justified but also likely to achieve its intended purpose.

• Good Medical Practice: Sharing information with colleagues paragraphs 50-53
• HIV infection and AIDS: the ethics of medical; confidentiality. Journal of Medical Ethics, 1992, 18, 173-179
• Survey of HIV patients' views on confidentiality and non-discrimination policies in general practise. BMJ 1996; 312 : 1463