BCPWA recently released a position statement regarding Pre- and Post-Test Counselling and Disclosure Directives. It reads as follows:
On November 18, that element (section 6.1) of the Communicable Disease Regulation (CDR) that required written consent before information about a person’s positive HIV-test results could be disclosed to anyone other than the Medical Officer of Health was repealed. This leaves the placing of a disclosure directive on their records in the PLIS-HIB (the lab results part of eHealth, into which all positive confirmatory HIV tests are deposited) as the only means open to individuals getting tested to ensure to a significant (though not conclusive) degree that their positive test results will be shared only with those health care providers to whom they give their keyword.
Securing a disclosure directive is a complicated, difficult and time consuming thing to do. But – other than relying on the ever weaker privacy guarantees contained in provincial law, which now allow the provincial Government to share any personal health information with anybody – it’s all an individual can do.
Accordingly, on December 29, 2010, the Board of Directors of BCPWA adopted by resolution the following position statement.
(1) publicly advises any person getting an HIV test to secure a disclosure directive on their PLIS-HIB records, and whatever “lock down” is available on their Health Authority electronic records,
a. if they do not believe themselves to be at risk of having contracted HIV within the preceding three months, and present with no apparent HIV symptoms, before they get tested; and,
b. if they believe themselves to be at risk of having contracted HIV within the preceding three months, or if they present with symptoms indicating advanced HIV disease, as quickly as possible after they have had the preliminary test; and,
(2) urges through all available avenues that health care professionals doing pre- and post-test counseling include in that counseling, as a matter of course, that clients contemplating getting tested for HIV
a. be advised of the certainty that their test results, if positive, will be deposited into the PLIS-HIB and will thereafter be available to any physician or other health care worker with authorized access, (and to anyone else who manages to hack the system), and to the provincial Government for any purpose it wants, including sharing the information with anyone it wants; and, that their test results and associated records (case notes, etc.) may be deposited into their local health authority’s electronic information management system(s) (e.g., Vancouver Coastal Health’s PARIS), from which they may be shared with an unknowable array of other persons;
b. be advised of the disclosure directive device available to them to limit to some degree the numbers and sorts of people who will have access to their test results on the PLIS HIB, and of the “lock down” device, if any, available to them to limit to such access to their information on their local health authority’s electronic information management system(s) (and that the provincial Government will still have unfettered access regardless, and that nothing can be done completely to preclude unauthorized access by others),
c. be counseled to put a disclosure directive on their PLIS-HIB records, and attempt to “lock down” their local health authority electronic records,
i. before they get tested, if they do not believe themselves to be at risk of having contracted HIV within the preceding three months and they present without symptoms indicating advanced HIV disease, and
ii. as quickly after they have had the test as they can manage, if they believe themselves to be at risk of having contracted HIV within the preceding three months, or if they present with symptoms indicating advanced HIV disease, and
d. be offered as much assistance as they require to secure a disclosure directive on their personal health information in the PLIS-HIB and a “lock down” of their local health authority electronic records.
A copy for download is available HERE.