Pam - you bring up an agonizing real-life example of the craziness we all
tap into surrounding HIV infection.  It is not only that the *mom* is being
deceiving.   One can, in theory, understand her wish for her husband not to
know that she is HIV-infected.  Certainly in Africa the stigma is huge and
women may be ostracized, abandoned, violently assaulted or even murdered if
it is known that they have HIV.  But in the case you describe, the
situation is compounded in that that the nursing staff are *required* to be
deceiving, also.

The situation you describe sounds so familiar.  We have testing centres
where couples can go (for a fee) for "voluntary counselling and
testing".  They often receive the pre-counselling and testing
together.  However, when they return for the results, one of them can
request that they be seen individually to receive the results of the test
and post-test counselling.  The staff at the testing centres describe how
they may know that only one member of the couple tests positive and the
other remains uninfected.  When this happens they encourage the infected
partner to reveal his status to his uninfected partner, but describe that
if often happens that he chooses *not* to, and they are ethically obliged
to maintain his confidentiality rather than give advice to the wife to
protect herself.  Thus confidentiality takes precedence over the right to
life.

IMHO there's something wrong with this and we need to re-think patient
confidentiality in the presence of a lethal disease which places others at
risk. In all other sexually transmitted diseases partners are found,
notified and treated.  Why is HIV different?  As healthworkers, how can we
knowingly allow someone to go on being placed at risk without warning
them??  Furthermore, tapping into the confidentiality/stigma issue just
perpetuates the spread of the disease.   I sometimes think this disease is
going to kill us all.  In Zimbabwe there are some areas where more than
half the pregnant women test HIV+.  In effect this makes the uninfected an
endangered minority.  I wonder when the rights of the healthy to remain
uninfected are going to be placed before the rights of the infected to
confidentiality?

Pam, I really feel for you!  I wonder if the baby is infected??  I guess
the mom is not allowed to breastfeed??

Another Pam, Zimbabwe
[log in to unmask]


>We have recently had a Mom (and she is not the first, unfortunately) who was
>HIV + have a baby who was admitted to the NICU.  Mom's condition is UNKNOWN
>to Dad!  Everyone was so sick about it.  Here this Dad is totally blind and
>not one of us can say a word.  Mom hides her medications at home and plans on
>doing the same with baby.  This couple looks like a normal couple.  Not
>someone who walked off of the street.  Where is this man's rights??  Mom is
>protected by patient confidentiality.  But what about Dad?  How awful is all
>of this for him!?!  The nurses would practically break down in tears every
>time he walked into the NICU to visit his baby.
>
>Having trouble believing people can be so deceiving.
>Pam Hendrix, RN, IBCLC, ICCE
>South Florida Hospital Based

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