Doctors Reform Society of Australia
			supporting health care reforms to ensure justice, equity and quality care for all
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11.1  General
11.1.1  The Human Immunodeficiency Virus (HIV) can cause an infectious disease and can lead to the Acquired Immune Deficiency Syndrome (AIDS).  HIV/AIDS refers to HIV infection and AIDS.
11.1.2  Guidelines on rights, education, prevention, testing, treatment and services are included in this statement.  Many of the issues discussed here are not unique to HIV/AIDS and can be applied to other blood borne infectious diseases such as Hepatitis B and C.  Given the social context in which this disease is seen, it is necessary to emphasise some points.
11.1.3  The DRS believes HIV/AIDS control should be integrated as part of a publicly funded sexual health program.
11.1.4  The DRS recognises the complementary role of government and non-government responses to HIV/AIDS in both preventive education and support services, which must be adequately resourced.

11.2  Rights
The DRS believes:
11.2.1  People living with HIV/AIDS  have the right to confidentiality, as do those requesting an assessment of their exposure to HIV.
11.2.2  Those infected with HIV/AIDS who persist in putting partners unaware of their status at risk need appropriate counselling.  The risk to others may outweigh an individual's right to confidentiality under certain circumstances.
11.2.3  People living with HIV/AIDS have the right not to be discriminated against on the basis of HIV/AIDS status in education, housing, employment, social services, health care and migration.  Access to medical, social and educational services relating to HIV/AIDS should be available to all who need them, regardless of income or geographical area.
11.2.4  Equal opportunity legislation should ensure that these rights are not infringed.
11.2.5  People living with HIV/AIDS have a right to expect quality health care at all times.  They should not be exposed to unethical or inappropriate medical treatment, experiments or medical trials.
11.2.6  Gender should not be used to exclude people from clinical trials or treatment and adequate attention should be paid to both genders. (see also Women's Health 8.1.6 and Ethical Medical Practice, Research 3.5.5)
11.2.7  HIV positive health professionals should be able to continue practising provided they avoid work which poses an unacceptable risk of transmission to their patients.
11.2.8  People living with HIV/AIDS should have significant input at all levels of  policy development.

11.3  Education and Prevention
The DRS believes:
11.3.1  Community education should be broad based to help minimise the spread of the virus and to counter prejudices which foster discrimination.
11.3.2  Education programs should also target specific groups at higher risk and be culturally appropriate for those groups.
11.3.3  Doctors need to be actively involved in the provision of education of those at higher risk as well as the broader community.
11.3.4  Preventive educational literature and programs may need to be explicit, and the DRS encourages GPs as well as other services to be an outlet for such material.
11.3.5  There is a need for expansion of needle exchange programs and freer availability of condoms to prevent the spread of the HIV.  (see also Tobacco, Alcohol and other Drug Use 6.3.8)
11.3.6  Prisoners should have access to condoms and clean needles. (see also Prisons 10.4 )
11.3.7  Contact tracing as a means of controlling the spread of the infection is important.  This must be done sensitively and in strict confidence.
11.3.8  Infected individuals should be counselled as to how best to inform their partners.  To prevent the spread of this disease risk behaviour needs to be minimised; and maximum support to those infected should be directed to this end.

11.4  Testing and Follow-up
The DRS believes:
11.4.1  Testing should be confidential with informed consent and appropriate pre- and post-test counselling.  Testing should be available through a range of facilities, including appropriately trained health workers, community practitioners, teaching hospitals and specialised clinics.
11.4.2  The notification of those with HIV/AIDS should not be done by identifying means.
11.4.3  Compulsory testing is opposed in principle.  (This includes people whose body fluids accidentally inoculate another, pre-surgical patients, pregnant women, refugees and migrants, partners of infected people, sex crime victims and perpetrators, sex industry workers, injecting drug users and health care workers.)  Appropriate counselling to facilitate testing those at risk of contracting or transmitting HIV is preferred.
11.4.4  The aim of testing for HIV is for the individual's knowledge of the status.
11.4.5  Screening for HIV should only be performed when blood or tissue donation is being contemplated.  Informed consent is still essential.
(see also 2. Health Rights )

11.5  Care and Treatment
The DRS believes:
11.5.1  People infected with HIV/AIDS have a right to whole-person management.  It should involve care of HIV-related illness, and other illnesses.  Partners, friends and family need education and care.
11.5.2  General practitioners are ideally suited to provide whole-person care and should be equal partners in the health care team.
11.5.3  The most appropriate care in most cases of terminal illness is community-based home care or hospice care.  Adequate resources must be available to enable this to occur.
11.5.4  Health care workers need to recognise the person's partner or significant other as the next of kin if requested.
11.5.5  Care-givers need to be educated in how not to become infected.
 

.		.	The Doctors Reform Society of Australia, Box 14, 4 Goulburn Street, Sydney 2000. Phone 02 9264-9084 Fax 02 9267-4393.	.
			This page was last updated on 29th January, 2003.
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