Confidentiality & Privacy - Ian
A rural general practitioner (GP) contacted a sexual health centre to ask for assistance to locate and Aboriginal patient named Ian. Ian had tested HIV-antibody positive but had failed to return for his results.
The GP was unable to locate Ian but thought he had moved to the city and gave the centre a possible address. Staff from the centre attempted to make contact by visiting the address on several occasions but found no one home. Finally they met a woman who claimed that Ian was her second cousin, who worked at the local Aboriginal Health Service (AHS), but knew that the centre was looking for someone. A message was left for Ian to contact the centre, but no other information was given to either cousin.
Through the AHS and his cousin, a message finally got through to Ian who made contact with the centre. No mention was made of HIV, only that test results were available from his GP. Ian contacted the GP and subsequently attended the centre.
Ian made it clear that he would not attend the AHS due to confidentiality concerns, which included the presence of his aunts, uncles, family friends, etc. He was feeling “isolated”, “shamed”, and “out of control.” At this point he disappeared into the bush and drank heavily. He noted “I went crazy”.
Finally he returned to the city and addressed some of his problems, but did not attend the AHS.
He went public about his HIV status at an Aboriginal seminar (with two close aunts present). This went very well. There were tears and recriminations. “Why didn’t you tell me?” Generally he was well-supported.
Ian believed he contracted HIV through a casual encounter. Whilst Ian did not know the contact’s identity, partner notification was not immediately possible, it was agreed he may be able to look into finding out the details of the contact e.g. through mutual friends, if he bumps into them again.
Provide opportunity for Ian to provide further details as time passes if he remembers any further contacts.
Case Studies courtesy of WA Partner Notification eLearning module available on lms.ashm.org.au