Dear Dr Remien, Thanks in advance for whatever advice you can offer, here's my question: I was diagnosed HIV(+) last October, I am in a relationship of seven years with a wonderful man. Telling him about my seroconversion was extremely hard, and a very painful step, but we dealt with it and moved ahead, we're still together, we just bought a house together, etc. We had in the last 2-3 years a somewhat open relationship (as long as we were both there if we were with someone else), but we always assumed that he was HIV (-), because of the two of us I was by FAR the more careless, and promiscuos. However in the recent past I have urged him to get tested and take appropriate steps to take care of himself...he's the type of person who would rather not know. Since I was diagnosed, I started volunteering some time in a local AIDS organization, and now to my real question: I recently did an intake (initial assessment) on a young college man who was diagnosed HIV (+) last year, and who I KNOW, (I was there) had sex with my partner in the last year or so. I was shocked and in a panic, my first impulse was to run and tell my partner, but knowing him I doubt that this would prompt him to get tested, but it would send him into a panic and anguish. Instead I have casually started to suggest that he get tested as well, but he still refuses. Should I tell them abou this situation I just came across?? I'm not even sure that this is the appropriate forum for this question, but this is eating me alive!!! Thanks.

I think there are two main issues in the situation you describe, and I think it is important that they be kept separate. First, you are certainly entitled to the opinion that your partner be tested, and have every right to encourage this out of your concern for his health and well-being. Most experts (and most people, in general) believe there are signficiant advantages to knowing about a positive serostatus. Chief among these is to monitor immune status and intervene, as needed, to maintain good health. And it sounds like your partner has probably engaged in behaviors that carry some risk for HIV transmission. However, the information you have about a client at the AIDS service organization, is and should remain confidential. It is not necessary for your partner to have that specific information to decide to be tested. If he has engaged in unprotected sex with other people (anyone of them could have been HIV+) and with you, then there has been risk. He already has good reason to be tested. The specific information you have about one of his past sexual contacts is not the issue, and again is confidential information. I hope this helps.