In January 2022, the Victorian Department of Health published the Victorian guidelines for managing HIV transmission risk behaviours (2021). Those guidelines in conjunction with the Public Health and Wellbeing Act 2008 (Vic), represent the public health mechanisms for managing those at risk of transmitting HIV to others in Victoria.
The guidelines are based upon a 4-stage approach. The 4 stages are:
- Stage 1 – counselling, education and support
- Stage 2a – counselling, education and support under advice from the HIV advisory panel or the chief health officer (CHO)
- Stage 2b – counselling, education and support under the advice from the HIV advisory panel or the CHO under a letter of warning
- Stage 3 – behavioural order
- Stage 4 – detention and/or isolation order.
Sections 3 and 4 provide for restrictions on the HIV-positive person’s behaviour and movement (through orders made under s 117 of the Public Health and Wellbeing Act 2008 (Vic)). Section 117 allows the CHO to make a public health order if the CHO believes a person is living with an infectious disease or has been exposed to an infectious disease (and is likely to acquire the disease), and that if the person has the disease, there would be a serious risk to public health (ss 117(1)(a)-(b)). A public health order can only be issued after reasonable attempt has been made to provide the person with information about the effect of the disease on their health and the risk posed to public health (or if it is not practicable to provide this information before making the order), and if the public health order is necessary to eliminate or reduce the risk of the person causing a serious risk to public health (ss 117(1)(d)-(e)). More information on factors to be considered is available in s 117.
A registered medical practitioner who receives a request in writing from the CHO must provide the requested information in writing as soon as is reasonably practicable (s 119).
The Public Health and Wellbeing Act 2008 (Vic) also allows the CHO to make an examination and testing order (s 113). If a person fails to undergo an examination or test, they may be detained for a period not exceeding 72 hours for the purpose of undergoing the specified examination or test. The CHO must provide a copy of an examination and testing order to any registered medical practitioner specified in the order as soon as is reasonably practicable (s 114). A registered medical practitioner who conducts an examination or test on a person in accordance with an examination and testing order must provide the written results of the examination or test to the CHO and to the person tested or examined, as soon as is reasonably practicable (s 115).
Specialist staff, known as partner notification officers, play an integral role in assisting the reduction of HIV transmission and the protection of public health. When the department is notified of a concern that a person with HIV appears to be putting others at risk of HIV, a partner notification officer interviews the person to assess whether the notification warrants further investigation or action. Based on that interview, the partner notification officer will make recommendations as to whether, and at what stage, management should commence under the 4-stage approach. If management commences, the partner notification officer is expected to be involved in case management through stages 1 and 2. A full copy of the Victorian Department of Health Victorian guidelines for managing HIV transmission risk behaviours (2021) is available here.
