Administering infant retrovirals without dads knowledge

allnurses Guide · Sep 4, 2017

I'm thinking, if dad doesn't even know that mom is HIV+,

then dad probably also is not listed as someone who has the

right to the baby's health information. Therefore, you likely

would not be able to discuss it with the father. So,

something along the lines of "I'm sorry, that is medical

information that I cannot share with you".

FolksBtrippin, BSN, RN · Sep 4, 2017

Dad has equal rights to mom concerning baby's information barring a court order. However, dad has no rights to mom's health information. It's a complicated situation and I would call the social worker before discussing any details with dad. I would administer the med.

A plan should have been made in team as far as what info would be given to dad. These decisions should not fall solely on the nurse.

In the situation described I would tell dad it's a med to prevent illness without going into details. If dad had questions I would tell dad that I would let the team know he has questions and that we would get back to him.

Then I would bring it up in team or call the social worker and doctor to discuss.

Horseshoe, BSN, RN · Sep 4, 2017

Does Dad have a right to know he is at risk himself after having had unprotected intercourse with Mom? What are UK laws with respect to informing sexual partners of HIV infection?

allnurses Guide · Sep 4, 2017

Does Dad have a right to know he is at risk himself after having had unprotected intercourse with Mom? What are UK laws with respect to informing sexual partners of HIV infection?

The General Medical Council has issued guidance to doctors.

"Informing sexual contacts of patients with

a serious communicable disease

10 You may disclose information to a known sexual contact of a patient with a sexually transmitted serious communicable disease if you have reason to think that they are at risk of infection and that the patient has not

informed them and cannot be persuaded to do so.

3 In such circumstances, you should tell the patient before you make the disclosure, if it is practicable and safe to do so. You must be prepared to justify a decision to disclose personal information without consent."

allnurses Guide · Sep 4, 2017

The medical team should be having a conversation with mum about transmission risks with regards to the above advice.

It is worth googling laws around medical staff and communicable diseases.

FolksBtrippin, BSN, RN · Sep 5, 2017

The General Medical Council has issued guidance to doctors.
"Informing sexual contacts of patients with
a serious communicable disease
10 You may disclose information to a known sexual contact of a patient with a sexually transmitted serious communicable disease if you have reason to think that they are at risk of infection and that the patient has not
informed them and cannot be persuaded to do so.
3 In such circumstances, you should tell the patient before you make the disclosure, if it is practicable and safe to do so. You must be prepared to justify a decision to disclose personal information without consent."

Okay, so we are talking about the United Kingdom here. I don't know if Dad's rights are equal to mom's under the law in the UK. And they are much more lax about healthcare privacy, particularly concerning reproductive stuff in the UK then we are in the US. My sister was in the UK when she was trying to get pregnant, and the nurse called from the office and told her husband that her pregnancy test was positive over the phone, without asking for her. That would not happen here.

Also, in the US you cannot disclose someone's HIV status without their permission, period. As a student I had a patient who was HIV+ from birth, had two children with a man, and never disclosed her status with him. Both of her children were negative. She kept him in the dark, even after having suffered fungal meningitis which left her disabled with a trach. The social worker continually encouraged her to disclose to her husband, but she never did. None of us had any right to tell him.

babyNP., APRN · Sep 5, 2017

In some US states, failure of a person to disclose HIV status to a sexual partner is criminal- and you can go to jail for it.

allnurses Guide · Sep 9, 2017

Okay, so we are talking about the United Kingdom here. I don't know if Dad's rights are equal to mom's under the law in the UK. And they are much more lax about healthcare privacy, particularly concerning reproductive stuff in the UK then we are in the US. My sister was in the UK when she was trying to get pregnant, and the nurse called from the office and told her husband that her pregnancy test was positive over the phone, without asking for her. That would not happen here.

And it shouldn't happen here either, absolutely unacceptable disclosure of personal information.

Also, in the US you cannot disclose someone's HIV status without their permission, period. As a student I had a patient who was HIV+ from birth, had two children with a man, and never disclosed her status with him. Both of her children were negative. She kept him in the dark, even after having suffered fungal meningitis which left her disabled with a trach. The social worker continually encouraged her to disclose to her husband, but she never did. None of us had any right to tell him.

It would be covered under communicable diseases and our public health teams would support here. You would have to had tried everything to encourage disclosure before you told dad but if that failed you can disclose but would need to evidence your attempts with mum and justify the risks for dad when challenged.