Patient obligations #
Section 14 of the South Australian Public Health Act 2011 (SA) sets out principles that apply to all controlled notifiable conditions. Under reg 5 of the South Australian Public Health (Notifiable and Controlled Notifiable Conditions) Regulations 2012 (SA), HIV is listed as a controlled notifiable condition for the purposes of the Act.
Section 14(3) of the Act defines a ‘principle’ that a person who has a controlled notifiable condition capable of being transmitted (including HIV) has a responsibility to take reasonable steps or precautions to avoid placing others at risk. This is a statement of principle, and breach of this responsibility is not accompanied by specific penalties, nor a breach of the criminal law. The principle, however, guides the application and interpretation of powers available to people like the chief public health officer in relation to controlled notifiable conditions like HIV, and may influence decisions regarding the application and design of public health ‘controls’ outlined in the Act – like powers to require a person to undergo testing, or to refrain from carrying out specified activities.
The Act does not define what constitutes a reasonable precaution in South Australia for these purposes. However, the South Australian Code for the case management of behaviours that present a risk for HIV transmission may be useful guidance. It states that taking reasonable precautions and exercising due care to prevent risk of transmission include:
- use of HIV treatments (including anti-retroviral therapy (ART)) to achieve and sustain undetectable HIV viral load
- use of condoms and lubricant
- sexual contact with partners who are taking PrEP
- safer injecting drug-use practice, including use of sterile needs and syringes.
Notably, s 14(4) also states a principle that as far as ‘reasonably practicable’, a person must not act in a manner that places themselves at risk of acquiring a controlled notifiable condition. This extends the principle regarding reasonable steps or precautions that applies to those living with HIV.
Under ss 73–80, the chief public health officer (CPHO) is vested with a significant range of powers to give directions if they believe that a person has, or has been exposed to, a controlled notifiable condition and that a public health order is reasonably necessary in the interests of public health (s 75(1)).
These powers include requiring the person to undergo testing, examination or counselling, requiring the person take specified action to prevent or minimise any health risk that may be posed by the person, requiring that the person be detained, and ‘such other direction as to the person’s conduct or supervision that the CPHO considers to be appropriate in the circumstances’.
If a person, who is subject to an order fails to comply, they are liable for a maximum penalty of $25,000.
Healthcare provider obligations (pre-contact tracing) #
Not defined.
