AIDS screening, confidentiality, and the duty to warn

Testing for the presence of HIV antibodies can provide a clear focus for public education and counseling as a foundation for behavior change. The cost-free and timely availability of professional testing for persons vulnerable to HIV is an essential part of the public health strategy to impede the spread of the infection. In order to protect the privacy of high-risk groups and be fair to clinicians, statutory confidentiality protection with specific exceptions for foreseeable harm to others would be an important adjunct to this strategy. It is conceivable that some individuals would alter their behavior in response to a mandatory screening program. The price for such a speculative public health benefit would be the invasion of privacy and financial cost entailed in the widescale collection of sensitive information, and the subsequent loss of trust and cooperation of persons vulnerable to HIV.