We read with interest the recent article by Dwivedi, et al. [1] on HIV disclosure. The article comprehensively discusses disclosure from the perspective of an HIV-infected individual and his/her family, especially children. However, there is another facet of disclosure that is probably unique to our settings which has not been included in this write-up. It is the strange problem of hesitation in revelation of their HIV status by the individuals (or their family members) who are positive, to the doctors. Sometimes the non-disclosure of a positive-HIV status may not harm others but intentionally not revealing the information creates a situation of potential harm to others.

It becomes difficult to ascertain whether ‘voluntary disclosure’ is the responsibility of the parents or non-disclosure of their (or their ward’s) HIV status, an unquestionable right to their privacy. Such scenarios are not very uncommon in our country, given the social stigma associated with HIV/AIDS. Parents also fear that revealing the seropositive status to the doctor would put them at risk of discrimination by the healthcare providers within the hospital or by others in the society. Though the stigma is understandable, failure to disclose the seropositive status to the treating physician puts the entire team of healthcare professionals at risk. Universal precautions have been devised precisely for such situations but the ground realities in resource-limited settings are far from ideal. It is also true that non-disclosure puts the child’s life at-risk by delaying appropriate diagnosis and prompt treatment.

Worldwide, many countries have invoked legal provisions to tackle this problem by making non-disclosure a criminal offence [2]. According to the Indian Penal Code (IPC), acts likely to spread infection to cause any disease dangerous to life, are punishable [3]. Laws criminalizing HIV transmission may be applicable when there is "intentional [and] malicious" transmission [4,5], but only drafting laws may not solve this problem, as the real solution lies in changing the societal perception. There is need to work with individuals as well as in the society, to make every one understand the importance of disclosing their HIV status to physicians to ensure faster diagnosis, appropriate treatment as well as the safety of treating team of healthcare-providers.

This peculiar aspect of HIV non-disclosure needs to be highlighted on a global platform for creating awareness and seeking solutions. Empowering the society at large with the right knowledge and attitude is the way forward.

1. Dwivedi P, Patkar P, Beard J. Necessity of systematic HIV disclosure in HIV-infected families: committed communities development Trust’s approach and intervention. Indian Pediatr. 2015;52:375-8.

2. Issues Paper; Criminalization of HIV Non-disclosure, Exposure and Transmission; High-level Policy Consultation. Oslo, Norway. Feb 2012. Available from: www.aidsdatahub.org/dmdocuments/criminalisation_of_ nondisclosure_exposure_and_transmission_issue_ paper_OSLO_2012_cat_19.1.pdf. Accessed June 04, 2015.

3. Jhabwala NH. Indian Penal Code, 13th edition. Mumbai: C. Jamnadas and Company; 1997. p.156-62.

4. Grover. A Report of the Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health, United Nations Human Rights Council, Fourteenth Session (A/HRC/14/20), 27 April 2010. Available from: www2.ohchr.org/english/bodies/hrcouncil/docs/14session/A.HRC.14.20. pdf. Accessed June 04, 2015.