Patient obligations #
Section 111 of the Public Health and Wellbeing Act 2008 (Vic) contains ‘principles’ that apply to the management and control of infectious diseases (including, HIV). These principles include that a person at risk of acquiring an infectious disease should take all reasonable precautions to avoid acquiring the infectious disease.
Further, a person who has, or suspects they may have, an infectious disease should find out whether they have an infectious disease, and what precautions they should take to prevent transmission to another person. Importantly, the person should take all reasonable steps to eliminate or reduce the risk of transmission.
A person who is at risk of acquiring or has, or suspects they may have, an infectious disease is entitled to receive information about the disease and any available treatment, and to access this treatment.
Failure to act in accordance with these principles does not attract a penalty.
The Victorian Department of Health provides guidelines for managing HIV transmission risk behaviours, which provide that ‘reasonable steps’ include:
- having a sustained undetectable viral load of less than 200 copies/mL
- engaging with appropriate clinical care and treatment monitoring
- consistent condom use with lubricant
- consistent disclosure of HIV-positive status prior to engaging in sex
- seeking confirmation from sexual partners that they are taking PrEP
- safer injecting practices, including using sterile needles and syringes and avoiding sharing of needles or equipment.
Healthcare provider obligations (pre-contact tracing) #
The Public Health and Wellbeing Act 2008 (Vic) has been amended to remove some earlier provisions relating to HIV testing and related processes. These changes remove the need for medical practitioners to provide prescribed information before testing for HIV. The broad intent of these reforms was to remove additional procedures for the ordering of a HIV test, and to bring HIV testing into closer alignment with legal requirements regarding any similar pathology test. These changes do not remove the general duty to seek consent for an HIV test, or to comply with information provision and other clinical processes that represent good medical practice.
The Explanatory Memorandum of the Public Health and Wellbeing Amendment Bill 2019 (Vic) that introduced the changes states:
‘The requirements in sections 131 and 132 of the Principal Act are considered unnecessary and out-dated, as they single out HIV by creating special requirements in relation to its testing. The repeal of these sections will have the effect of HIV being treated like any other blood-borne virus or medical condition’.
Previously, s 31 of the Public Health and Wellbeing Act 2008 (Vic) required that a healthcare practitioner only test for HIV in circumstances where the person has been given the prescribed information in accordance with the regulations. This is no longer a requirement in Victoria.
