Week 2 (Day 4) - HIV tutorial on legal aspect (Grevious bodily harm and duty to third party)

Question 1

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Answer 1

Infidelity Scared of her husband’s reaction Worried about being force to go back to Africa by husband Guilt/shame Doesnt want people to know

Question 2

Duty of care What would Grace’s HIV clinician priority be when deciding whether or not to disclose this information? (bear in mind the husband is a third party here - does it make a difference if he is a known or unkown third party )

Answer 2

The HIV clinician’s priority is to Grace and helping treat Grace for the HIV Can advise Grace to disclose this information to her husband but she does not have to As the husband is an unkown third part the HIV clinican has no duty of care to him If the husband is known, the clinican is allowed to break confidenitality but does not have to

Question 3

If Grace declines to start on treatment, does she have to tell her husband?

Answer 3

It is illegals under the grounds of grievous bodily harm to have sex with someone when you have HIV - recklessness If her HIV was controlled, would not have to disclose

Question 4

Why is it not deemed reckless to have sex with a HIV negative person if you are HIV positive and have an undetectable viral load?

Answer 4

This is because an undetectable viral load is deemed untransmissable and therefore you do not pose a potential risk to the transmissal of HIV to the HIV negative person

Question 5

What is the duty of the obstertician if Grace is HIV positive?

Answer 5

Duty of care is to Grace Again has the right to break confidentiality but does not have to - immediate care is for grace and the pregnancy

Question 6

How is mother to child transmission of HIV reduced?

Answer 6

HAART during pregnancy Vaginal delivery if viral load undetectable If viral load detectable, then caesarean section and PEP for the baby (for 28 days) Exclusive formula feeding for baby also

Question 7

What is the duty of care to Grace and to her husband by the GP? (say the duty of care for if the husband was and wasnt the GP’s patient)

Answer 7

If husband was not a patient

• Then GP has a duty of care to Grace, advise that disclosure is usually best option

If husband was a patient

• Then GP has a duty of care to Grace, advise that disclosure is usually best option
• However also has a duty of care to husband and will have to notify the husband of the HIV infection

Question 8

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Answer 8

As an HIV clinician, dont want to make the husband feel blame as this can stop him coming to the clinic at all

Promote the benefits of adhering to treatment - ie reduced infections and better well being

Try and persuade the use of condoms and to disclose his HIV status to women whom he has sex with

Question 9

If Nelson, knowingly has HIV, and chooses to have unprotected sex with woman, how should he be counselled in regards to Scottish Law? (4 points)

Answer 9

Can be convicted of transmitting HIV under grievously bodily harm charge – 4 guidelines * Person must knowingly have HIV at the time of transmission * Must have unprotected sex with someone who later becomes HIV negative - reckless * If your HIV status is not disclosed prior to sex * If you can be proven to be the only source of the HIV infection