Don’t Keep This Secret

Image courtesy of [Phaitoon] / FreeDigitalPhotos.ne

Image courtesy of [Phaitoon] / FreeDigitalPhotos.ne

I’m moving through my January book club book – All Decent Animals – by Oonya Kempadoo. I still haven’t figured out where it’s going, as there are several story lines, but one interesting issue it’s raised is the ethics involved in deciding whether to tell your sexual partners that you have been diagnosed with a sexually transmitted disease. One of the characters in the book is HIV positive – it is now showing symptoms of having become AIDS – and he is refusing the advice of friends that he needs to inform his partners.

I can imagine that would be a difficult conversation to have with someone. How would you break the news to someone that you have AIDS, and they need to get tested?

Last year I read an article on NPR that talked about a program in one of the Northwest states that called partners of people who were diagnosed with gonorrhea. The program is run by the state’s health department. One of the workers interviewed said the conversation goes something like this:

Worker: Hello, is this Elizabeth?

Person: Yes

Worker: Were you born on such and such a date?

Person: Yes

Worker: I’m calling to let you know that you may have been exposed to gonorrhea and you might want to get tested.

The worker said she waits a minute (there is usually silence on the other end of the line), then asks what the person knows about gonorrhea, and the conversation goes from there. This wasn’t in the article, but I’m sure, as a state health department worker, she is able to provide the caller with information about testing and treatment options available to the person.

Gonorrhea, however, is curable (though the article reported that because people aren’t being treated, some incur able strains are popping up). I can imagine the conversation between a health worker and someone who had been exposed to HIV / AIDS would cause quite a different set of feelings than those felt by the person exposed to gonorrhea.

This particular program, and I’m sure all similar ones, keeps the identity of the infected person secret / anonymous. The worker interviewed said that she is often asked for the name of the infected person, the person she is calling on behalf of. That is a prudent thing to do, in my opinion. While it is possible for the “Person” to do some detective work in the area of their sexual partners and track down the potential infector, I think the more important thing is that they are notified, and given the opportunity to get tested and begin treatment, if necessary.

I hope many more states would consider implementing programs like this. I think it would help to prevent the spread of STDs. Many people simply do not get tested for STDs. So someone who has been exposed to one can go on to have sex with multiple other partners, exposing them to the risk of transmission as well. I think it is ethical and moral, if you have been diagnosed with an STD, that you try to make contact with those you have had sexual contact with, and you refrain from having unprotected sex in the future.

The character in the book didn’t want to have to face his previous sexual partners. I understand that feeling. No one likes to give bad news, especially news like this. But he performed a grown-up act by engaging in sexual activity. He should now perform a grown-up act and reveal his illness. If he can’t muster up the strength to do it himself, he should enlist the aid of friends, who can act as the anonymous notifiers, like the state program mentioned here. Failure to do so is childish behavior. While this is all happening in the context of a fictional novel, I think we should be spreading this message as part of preventive health care actions in the real world.

[I’ll update the post once I finish the book to indicate if the author allowed the character to make the grown-up choice]

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