The impact of confidentiality on HIV and AIDS transmission in Greater Mafikeng sub-district

Abstract

Confidentiality in the HIV and AIDS field is a controversial issue. Health care professionals are ethically and legally required to keep all information about their patients and clients confidential. Any information about the patient or client's illness or treatment can only be divulged to another person with the patient's or client's consent. Although South Africans generally know about HIV and AIDS, many do not perceive themselves to be at risk, and are not willing to accept the link between high-risk behaviour and actual HIV infection. The problem arises when the patient or client tests HIV positive and refuses that his or her partner be informed, and at the same time, there is no guarantee that safe sex will be practised, instead, new people will be infected in the process, as some indicate that "they will not die alone". It is clear that not everyone infected with HIV takes all the necessary steps to protect others or themselves. The study investigates whether confidentiality facilitates HIV and AIDS transmission or not.

The study used descriptive research design and quantitative research method because of the complexity of the subject matter. Data was collected by asking close-ended questions where respondents could answer with regard to issues of confidentiality and HIV and AIDS. The population for the study composed of both male and female clients and patients in Voluntary Confidential Counselling and Testing (VCCT) sites, in Greater Mafikeng Sub-district. The sample of 200 was chosen from patients and clients aged from fifteen years and above, at VCCT sites (100), including the general practitioners consulting rooms (40) and home-based care settings (60). Tables, graphs and percentages were used in the analysis of data. The study confirmed that, there is facilitation of HIV transmission by maintaining confidentiality and not disclosing HIV status to sexual partners and significant others. However, some HIV positive respondents wanted to disclose their status but were prohibited by fear of the reaction of significant others as well as sexual partners, thus making them to continue with their sexual life as if all is well. Recommendations emerging from the study deal with aspects which include among others, re-looking at the confidentiality clause and extending to other categories of health professionals involved with counselling patients and clients around HIV and AIDS, formal authority to inform sexual partners of patients and clients about their HIV positive status.