The 2019 Management of people with HIV infection who risk infecting others NSW Health policy directive (NSW Guidelines) provides for 3 different levels of management:
Local management, which includes:
- initial steps – counselling, education and support
- case conferencing
- contact tracing or partner notification
- seeking advice from the Chair
Level 1: Supported management, which includes:
- letter of warning
- the ongoing assessment by the panel for management of people with HIV who risk infecting others
- discharge from supported management
Level 2: Public health order, which may include orders to:
- refrain from specified conduct
- undergo specified treatment (including anti-retroviral therapies (ARTs))
- undergo counselling by one or more specified persons, or by one or more persons belonging to a specified class of persons
- submit to the supervision of one or more specified persons or of one or more persons belonging to a specified class of persons
- undergo specified treatment at a specified place
The NSW Guidelines state that the making of a public health order should only be considered when such an order is judged the most effective way to prevent risk to public health, and where all other management options have been unsuccessful. An authorised medical practitioner is required to take into account the principle that any requirement restricting the liberty of a person should be imposed only if it is the only effective way to ensure that the health of the public is not endangered, or likely to be endangered. Concerns or evidence of a person’s breach of their public health order should be referred to the ministry for consideration and appropriate action.
