EthicsLab Essentials

HIV Disclosure: New Ethical Approaches

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New research findings regarding HIV status will impact how we understand and practice disclosure of HIV status of patients… specifically whether or not to disclose a sick patients’ HIV serostatus to their family or partner. The new research demonstrates that when an HIV-positive person sticks to their treatment, their HIV is undetectable and untransmittable (U=U). Our three guests are working together on bioethical projects to spread the awareness of U=U.

Our guests in this episode include:

  • Jamie Crist, JD, MA a Clinical Ethics Fellow at the Baylor College of Medicine, Houston Texas and doing clinical ethics consultation at Houston Methodist Hospital. Jamie has a JD and Masters in Bioethics at Case Western University.
  • Nicole Meredyth, MD, is a clinical ethics fellow at Weil Cornell Medicine in New York Presbyterian Hospital. She is also completing her surgical residency at Weil Cornell University.
  • Nekee Pandya, MD; is a clinical ethics fellow at Weil Cornell Hospital and also a hospitalist at that hospital.

    • Additional resources relating to or referenced in this episode:

    • HIV Law and Policy
    • CDC HIV Treatment as Prevention
    • HIV viral load and transmissibility of HIV infection: undetectable equals untransmittable

      • Sessions are monitored on a monthly basis by CME office and content confirmed to be evidence based and without bias. Secondly, the CME Program Director and CME Coordinator reviewed and approved all material prior to the educational activity being approved to confirm that the educational activity was evidenced based. Peer reviewed journals and other literature are used, as applicable during discussions.

      References for Further Study:

      • Eisinger, R. W., Dieffenbach, C. W., & Fauci, A. S. (2019). HIV viral load and transmissibility of HIV infection: undetectable equals untransmittable. Jama, 321(5), 451-452
      • Cohen MS, Chen YQ, McCauley M, et al. Prevention of HIV-1 infection with early antiretroviral therapy. N Engl J Med 2011;365:493-505.
      • Ngure, K., Ongolly, F., Dolla, A., Awour, M., Mugwanya, K. K., Irungu, E., … & Wamoni, E. (2020). “I just believe there is a risk” understanding of undetectable equals untransmissible (U= U) among health providers and HIV‐negative partners in serodiscordant relationships in Kenya. Journal of the International AIDS Society, 23(3), e25466.
      • Calabrese, S. K., & Mayer, K. H. (2019). Providers should discuss U= U with all patients living with HIV. The Lancet HIV, 6(4), e211-e213.
      • Tobin, S. C. (2019). U= U gains strength with release of PARTNER2 data. Aids, 33(3), N1.
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