InterPress News Service (IPS); 7 August 1997
Lewis Machipisa

While conceding that privacy over health matters is a bic human right, some argue that in the long run, excessive emphasis on confidentiality, can lead to increased stigma, discrimination and can perpetuate denial of the epidemic, thus impeding prevention efforts.

The debate comes at a time when women activists are up in arms over a draft law which proposes up to 20 years mandatory jail term for anyone who knowingly infects another with the virus that causes the Acquired Immune Deficiency Syndrome (AIDS), excluding spouses. The Bill is now before Parliament.

About 10 percent of Zimbabwe's more than 11 million people are infected with the Human Immunodeficiency Virus (HIV), according to the Ministry of Health. Some 500 people die weekly from AIDS, Health Minister Timothy Stamps has said.

At the moment, doctors or those caring for people with AIDS or HIV positive patients, risk being sued if they disclose their patient's status without consent.

But according to Norman Nyazema, a pharmacist, if HIV/AIDS carers do not know or cannot discuss their patient's health status, confidentiality rapidly becomes secrecy that benefits neither the patient, the carer, nor any other people involved.

"The issue of confidentiality needs to be researched as it centers on human rights. But in a case where two peple are legally married, the other partner should be told that his or her partner has AIDS irrespective of whether that partner agrees or not," says Rumbi Nhundu, assistant director of the Women's Action Group (WAG).

"What confidentiality is there when two people are sleeping together? I think it's logical to let the other partner know the status," Nhundu told IPS.

But Gladys Siwela, communications manager for Women in Law and Development in Africa (WILDAF), argues that the right to privacy must be maintained. "It's a very controversial issue. It's their (HIV/AIDS sufferers) own right (privacy) and it's up to that person to say whether he or she wants her status to be known. The whole issue hinges on human rights.

"It should not be the law that forces one to save the other party, but conscience that forces you to practice safe sex," Siwela adds. "Legislation does not protect anybody, but it's people's attitudes and that's where we should put more effort."

But withholding information on a person's HIV status from a sexual partner puts the partner at risk, Nyazema says. According to him, counselors or health professionals should be allowed by law to notify partners, if a client refuses to do so.

"There should some statutory instrument that can protect an AIDS care provider should he (or she) decide eventually to disclose a person's status," Nyazema says.

But what about that person's right to privacy?

"In the case of HIV, you are looking at individual ethics versus collective ethics. You are trying to prevent somebody from spreading the disease, because everybody has a right to live. So, you balance the right to protect somebody to live and the right not to disclose that somebody has HIV," explains Nyazema.

"I am not saying a sick person does not have a right to privacy, but when it comes to a disease like HIV for example, there is what we call individual ethics versus collective ethics. Who are you trying to protect, this particular individual or the society? At the end of the day, the society wins the day."

In Zimbabwe's socio-cultural setting, where there is no gender equality, women are often unable to practice safe sex, because they have little control over their sexual relationships.

It is not surprising to find men striving hard to hold back information relating to sexual matters from women, because culturally, female ignorance of sexual issues is considered a sign of purity.

But equating ignorance with innocence is inhibiting some women from seeking information that is critical to their well-being, health experts warn. For example, 42 perent of the HIV/AIDS sufferers in the world are women.

"The infected should inform the other partner so that they can choose a way of protection to avoid infecting another person," says Zimbabwe Aids Prevention Project manager Rhoderick Machekano.

"Notification of one's status will give direction to what choices to make in terms of protection. There should be proper counselling to avoid breakup of marriages, because maybe the other partner didn't want to be told and may end up with stress," Machekano adds.

"The human rights issue is always a controversial thing. In one way you are protecting one's right to privacy while on the other, you are denying the other party the right to know and to be aware of potential danger," says Machekano. (end/ips/lm/pm97)

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