These unjustified fears and beliefs should not lead to discriminatory actions in relation to medical care, access to housing, education, employment and other opportunities. Fellows have a responsibility to work to counteract inappropriate reactions to HIV disease in their communications and professional activities. The best available psychiatric care should be available to all patients irrespective of HIV serologic status or suspicion of risk of HIV infection. A variety of difficult and possibly conflicting responsibilities have been produced by the HIV epidemic.
Confidentiality is an essential part of the doctor-patient relationship.
In general, psychiatrists and their staff should never give information about a patient s HIV status to a third party without the patient s written permission. Any breach of confidentiality should occur only in very specific circumstances. Fellows may at times need to consider breach of patient confidentiality where there is a need to protect other persons who may be at risk of contracting HIV infection. There are two sets of circumstances where this may be particularly relevant. In such circumstances the psychiatrist should work with the patient to obtain his or her agreement to modify such behaviour so as not to place others at risk or to notify the persons who are at risk of infection.