Patient obligations #
Section 99 of the Public Health Act 1997 (ACT) outlines principles to be applied in relation to notifiable conditions. For the purposes of the Act, HIV is listed as a transmissible notifiable condition.
A person who engages in activities that are known to carry a potential risk of exposure to HIV (and to any person responsible for their care, ‘the responsible person’) has the following responsibilities:
- to take all reasonable precautions to avoid acquiring HIV
- if the person believes that they have been exposed to HIV, to ascertain whether they have acquired HIV, and what precautions should reasonably be taken to avoid exposing others to HIV
- if the person believes that they have acquired HIV or are likely to have acquired HIV, to take reasonable measures to ensure that others are not unknowingly placed at risk through any action or inaction of the person (or the responsible person).
Note: This duty applies to all persons, regardless of HIV status.
A person who satisfies any of the above criteria has the right to privacy, and the right to receive all reasonably available information about the medical and social consequences of HIV and any proposed treatment.
A ‘responsible person’ means a medical practitioner, nurse, counsellor who counselled the other person in relation to the condition, or a person who is responsible for the care, support or education of the other person.
The term ‘reasonable precautions’ is defined to an extent in reg 21 of the Public Health Regulations 2000(ACT) as including precautions taken on the advice of a medical practitioner (including an authorised medical officer) or an authorised officer.
Further, in reg 21, a person who knows, or suspects, they have HIV, or knows, or suspects, they are a contact of a person who knows, or suspects, they have HIV, must take reasonable precautions against transmitting HIV.
Similarly, the responsible person who knows, or suspects, that the other person has HIV or is a contact of such a person, must also take reasonable precautions to prevent the other person from transmitting HIV.
Where a person or responsible person fails to take reasonable precautions, they may be subject to a penalty of up to 10 penalty units.
Healthcare provider obligations (pre-contact tracing) #
Under s 102 of the Public Health Act 1997 (ACT), if a medical practitioner or nurse has reasonable grounds to believe that a patient has, or may have, HIV, they must give the patient information about:
- transmission of HIV and how to prevent transmission to others, unless they have reasonable grounds to believe that the patient had been given this information by another medical practitioner or nurse
- anything determined by the chief health officer
- the patient’s rights to privacy and to receive all reasonably available information about the medical and social consequences of HIV and any proposed treatment.
Further, if the HIV-positive patient agrees, the medical practitioner or nurse is to make reasonable arrangements for the patient to receive counselling in accordance with any applicable code of practice, and to ask the patient for information to comply with the medical practitioner’s or nurse’s duty to notify the chief health officer. Failure to comply with the above amounts to unprofessional conduct, and the patient is entitled to make a voluntary notification about such a failure to the national agency under the Health Practitioner Regulation National Law (ACT).