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While such improper disclosure may actually be beneficial to the at-risk people in the patient's life, such as unprotected sex partners, when viewed from a societal point-of-view, such disclosure would be improper. Most people who know that they have a contagious fatal disease will take steps to limit other's exposure to that disease. Therefore, it is in society's best interest to encourage testing. The fact that some people will continue to knowingly expose others to the disease is not a compelling reason to break confidentiality, because many people would forego testing if they believed that their results would be made public. The number of people put at risk in each scenario is unequal; therefore the ethical consequences of a breach of confidentiality are worse than the ethical consequences of maintaining confidentiality in the face of suspected dangerous behavior.
From a social perspective, the ramifications of an improper disclosure can be absolutely disastrous. HIV / AIDS still has a stigma attached, and people assume that patients either engaged in unsafe sexual behavior or drug abuse habits. Publication of the fact that someone has HIV / AIDS will almost certainly result in that person being treated differently...
These differences can be minor, such as the loss of a friendly acquaintance, or major, such as the denial of health care or social services because of one's HIV / AIDS status. Moreover, because HIV / AIDS can be successfully managed, though not cured, a person may live a long and relatively healthy life with no indicators of the disease. Therefore, a breach of confidentiality could have a long-lasting impact on quality of life, which, in turn, may impact patient health.
References
American Association for World Health. (2001). Fact sheet: confidentiality and HIV testing.
Retrieved February 1, 2009, from the Body.
Web site: http://www.thebody.com/content/prev/art33036.html
University of Miami. (2005). Violation penalties (HIPAA). Retrieved February 1, 2009 from Miller School of Medicine
Web site: http://privacy.med.miami.edu/glossary/xd_hipaa_sanctions.htm
Web site: http://www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/index.html
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