HIV and the Mentally Ill: An Approach to the Legal Issues

The epidemic of human immunodeficiency virus (HIV) requires mental health clinicians to make many decisions that present legal dilemmas, yet few clear rules of law exist that address HIV antibody testing, confidentiality of information about patients' HIV status, clinicians' duty to protect third parties, and discrimination against HIV-infected individuals in psychiatric settings. The author recommends a balance between the legal interests of infected and uninfected persons in addressing these issues. HIV antibody testing or disclosure of information about an individual's HIV status without informed consent should be strictly limited and done only when clinically necessary. Nondiscriminatory treatment for HIV-infected patients and protection of uninfected persons is best approached by use of universal infection control procedures and individualized clinical judgment.