An individuals duty of disclosure of the carriage of a potentially infectious chronic sexually transmitted pathogen prior to sexual intercourse is a highly contentious issue. This is a very difficult area for patients and clinicians to discuss, however guidelines are relatively silent on the subject.

There is a paucity of data supporting any particular strategy for disclosure and uncertainty about what the desired outcome measure is.

Clinicians may look to civil and criminal case law to guide their patients- however outside the growing body of HIV-related litigation there is no clear advice around the responsibilities of carriers to disclose or even limit the spread of HSV, HBV, HPV or HCV through personal behaviours. Despite this limited evidence many clinicians and patient advocacy groups hold firm views on the value of disclosure and the consequences of a failure to do so.

Regarding genital HSV infection, traditional positions opposing disclosure have to some extent been challenged by the clear demonstration of interventions that couples may take that could reduce transmission risk to an uninfected partner. Arguments can be put forward that awareness of disease in a partner may promote condom usage and selective abstinence, however, many of these strategies can be promoted or initiated by HSV carriers without disclosure.

The participants in this debate have been asked to take opposing views and highlight the extremes of the arguments for and against disclosure so as to challenge received opinion in the hope of clearly identifying the unresolved questions and stimulating debate on this issue.

View

Download