HIV orders rarely used in NSW

In the wake of a sensational court case in Melbourne and an arrest in Adelaide, the NSW health department revealed this week there are no current health orders standing against HIV-positive people in this state.

The Michael John Neal case in Melbourne has highlighted the existence of state public health orders that are occasionally placed on people accused of regularly putting others at risk. Adelaide police have since arrested another man on HIV-related charges.

The case has put HIV exposure in the headlines and Victorian and South Australian health departments have both been accused of mismanagement, losing track of individuals monitored for placing others at risk.

In NSW, the Public Health Act provides for health orders to be made against individuals who place others at risk, but Dr Kerry Chant, director of health protection, said very few cases had to go that far.

In fact she stated the greater public health concern was unwitting exposure.

There’s a small component that put others at risk, but the major issues of ongoing transmission are those who don’t know they are infected and those practising unsafe sex -“ that’s the source of the greatest pool of infection, she said.

People with HIV are overwhelmingly concerned about not infecting others.

Chant said that systems had been set up in NSW so that newly diagnosed people were given the counselling and support to help them make the right decisions to protect others. But those cases where counselling was not effective were dealt with on a case-by-case basis.

There may be a response such as a letter of warning from the department, which tells people not to do certain things, she said.

But there is also the capacity to issue public health orders. They’re a more powerful legal tool, they can require a person not to engage in certain behaviours, or undergo treatment or be under supervision, or to be detained.

We have an expert panel that provides advice on the appropriate management strategies for each individual case, she said.

Chant said by focusing on the protection of public health, a holistic approach to managing patients’ needs is usually the best solution.

I’m confident we have good process in place, she said.

At the moment, no current orders are in force against people for placing others at risk of HIV infection.

We have a responsibility to deal with the cases that come to our attention to ensure the public are protected, but the community has a responsibility as well. There shouldn’t be any complacency because we have this process.

ACON CEO Stevie Clayton, who sits on the health department’s expert panel, said no system was going to be foolproof, but she believed NSW had the best possible system to handle this phase of the epidemic.

We think that process has been working well. We don’t think there have been problems with it, she said, but added cautiously, no system is absolutely infallible.

We think it draws the right balance between the rights of the individual that’s infected and the rights of the public to be protected from transmission.

In the years that I’ve been on that group, I’ve never see a malicious case to date -“ it’s very much those with intellectual disabilities, mental problems.