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Confidentiality and disclosure of HIV infection: HIV-positive persons' experience with HIV testing and coping with HIV infection in Latvia

The objective of the study was to explore retrospectively HIV-infected individuals' experience with HIV testing, counselling and the issue of confidentiality in the Latvian context. A qualitative study using grounded theory approach and based on semi-structured in-depth interviews was implemented. Thirteen HIV-positive individuals above 18 were selected, using purposeful sampling, from the 63 HIV-positive individuals registered in Latvia between 1987 and 1997. HIV-infected people are worried that doctors sometimes disrespect confidentiality. Confidentiality was found to be a basic prerequisite for building trusting relationships between an HIV-infected individual and a doctor within the counselling process from the first visit to follow-up counselling and as one of the most important factors of the formation and proper functioning of the physician-patient relationship. Trusting relationships will not be established in situations when an HIV-infected individual is not seen by a doctor as a human being with needs, worries and without understanding his or her situation. Breaches of confidentiality should be seen as shortsighted and can diminish the public's trust in physicians. Counselling should be sensitive to the cultural, historical traditions and prevailing public health practices, social values and political differences in attitude toward the importance of treating someone as a private individual.