Questions asked on who should be the authority to reveal one’s HIV status 

Health: The 29-year-old woman, who was claimed to be an alcoholic and an alleged HIV positive, is admitted to the Thimphu referral hospital for treatment, health officials said.

A post about her alleged HIV status and risky sexual behavior went viral on social media after Chithuen Phendey Association, a CSO that helps recovering alcoholics posted a letter it had written to police seeking their intervention in rehabilitating her.

Health officials said she was admitted to the hospital on December 9 for detoxification and has an attendant from Chithuen Phendey.

The association’s post alleged that despite knowing her HIV status, she continues to drink and sleep on the streets, from where men pick her every night. “It’s also assumed that by now she might have contacted sex with at least 50 men,” the letter alleged.

Chithuen Phendey’s executive director Tshewang Tenzin said he shared the letter on social media in the interest of public health and not to imply that they received no support from police.

“I posted it on social media out of desperation because I thought it’s a problem that needed immediate response,” he said. “I have seen her being picked up by men.”

While cautioning the public, the letter has also thrown up questions on who should be responsible for cases such as hers and who, in the interest of public health, should at all be the authority on revealing an individual’s HIV status.

The health ministry and CSOs it works closely with are aware about her health issues and have regularly intervened to provide her treatment and employment.

But officiating secretary Dr Ugen Dophu said the ministry and its relevant programme should still intervene in handling the case even though it was the police’s help that the association had sought.

“Breaking one’s confidentiality will not necessarily stop other people from having sex,” he said. “Instead, the person will be marginalized which would build up more anger in them.”

According to sources, the woman is a divorcee with a nine -year old daughter, abandoned by her family and husband, which could have been the cause behind her drinking problem.

Chithuen Phendey’s allegation of her HIV status has however concerned Lhak-sam, the Bhutanese network of people living with HIV.

Lhaksam’s executive director Wangda Dorji said such allegation would affect not only her but also her family. “Irrespective of her HIV status, the association is not allowed to reveal such information,” he said. “It’s a violation of human rights and such allegation would not only shame HIV positives but also discourage people from getting tested.”

He said that according to UN estimates, there are still more than 700 HIV positives undetected in the country. When men take advantage of a woman under the influence of alcohol, he said, it’s not right to blame her, irrespective of her HIV status.

Officials at the Health Information Service Centre (HISC) are also concerned about the impact such an allegation would have on the work done to de-stigmatize HIV.

Head of HISC Ngawang Choida said all health personnel who are bound by the ethics and the policy to maintain confidentiality of their clients and patients.

“This is sad and we are not in favour of what Chithuen Phendey is alleging,” he said. “We all are at risk and she is not the only one who should be held responsible. Others are equally responsible.”

Chithuen Phendey’s executive director Tshewang Tenzin said he did not reveal the woman’s name but only brought it out as an issue.  He had also posted, section 410 of the Penal Code which states that  “A defendant shall be guilty of the offence of criminal nuisance, if the defendant knowingly or recklessly creates or maintains a condition including spreading of dangerous disease that injures or endangers the safety or health of the public.

Wangda Dorji said in case of HIV diagnosis, the health officials are the first ones to know about one’s status and if they don’t reveal, confidentiality is usually maintained.

The Bhutan medical council regulations mandate all health personnel to keep patient information confidential except where disclosure of patient information is allowed by ethical and legal obligations. Maintaining professional confidentiality is listed as one of their duties to patients, under the code of conduct.

Sonam Pelden