At a July 24 meeting in Sydney, Australian health ministers introduced a policy change that would require doctors to report HIV patients they believed had knowingly infected others. "We have a very strong public health prevention approach to HIV, and we have protocols for dealing with people who are engaged in reckless behavior, but this provision is for that very small group of people who willfully and intentionally infect others," said Bronwyn Pike, Victoria's health minister.

"It's very important to affirm that this is not about mandatory reporting of everyone who has HIV, or changing the overall public health approach, but it is recognition that there is a very small group of people who we must know about," said Pike. "Mandating doctors to tell the Health Department is one way of us being able to have a good public safety approach."

The proposal comes as three Victoria men are before courts on charges of intentionally or recklessly infecting others with HIV.

Australian Federation of AIDS Organizations Executive Director Don Baxter and Michael Wooldridge, the federal government's chief HIV adviser, are backing the policy change. "We would agree with that approach where it's very clear to the doctor that the person is intending to infect someone else," said Baxter.

But civil libertarians are slamming the proposal. Robert Niemann, spokesperson for Liberty Victoria, called it a "major and obvious attack" on patient-physician confidentiality. The decision could discourage people from learning their status and communicating openly with the doctors, which could ultimately affect doctors' ability to treat patients, he said.

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