Physician breach of patient confidentiality among individuals with human immunodeficiency virus (HIV) infection: patterns of decision. 1990

J A Schwartzbaum, and J R Wheat, and R W Norton
Department of Biostatistics and Epidemiology, University of Tennessee, Memphis 38163.

To determine whether the sex, race, or sexual preference of a patient infected with immunodeficiency virus (HIV) influences a physician's decision to breach patient confidentiality, Tennessee primary care physicians were mailed a questionnaire containing a case study in which an HIV-infected patient presented a risk to a third party. Eight different descriptions of the sex, race, and sexual preference of the hypothetical patient were distributed randomly among the physicians, one description to each physician. The physicians were asked to decide whether to maintain confidentiality, notify the health department, or inform the patient's partner. Responses of 199 White male physicians were analyzed using an unconditional saturated logistic regression model. The odds ratios for these physicians saying they would send the patient's antibody status to the health department extend from 18.4 (95 percent confidence interval: 1.3, 260.1) for Black homosexual males to .5 (95 percent CI: 0, 11.5) for White homosexual females. The odds ratios for White male physicians saying they would inform the patient's partner range from 7.5 (95 percent CI: .8, 69.2) for Black heterosexual males to 1.0 (reference category) for Black homosexual females. The results suggest that when physicians decide to protect a third party by breaching an HIV-infected patient's confidentiality, their decision may be influenced in some cases by the race, sex, and sexual preference of the patient.

UI MeSH Term Description Entries
D008297 Male Males
D010817 Physician-Patient Relations The interactions between physician and patient. Doctor-Patient Relations,Doctor Patient Relations,Physician Patient Relations,Physician Patient Relationship,Doctor Patient Relation,Doctor-Patient Relation,Physician Patient Relation,Physician Patient Relationships,Physician-Patient Relation,Relation, Doctor Patient,Relation, Doctor-Patient,Relation, Physician Patient,Relation, Physician-Patient,Relations, Doctor Patient,Relations, Doctor-Patient,Relations, Physician Patient,Relations, Physician-Patient,Relationship, Physician Patient,Relationships, Physician Patient
D011795 Surveys and Questionnaires Collections of data obtained from voluntary subjects. The information usually takes the form of answers to questions, or suggestions. Community Survey,Nonrespondent,Questionnaire,Questionnaires,Respondent,Survey,Survey Method,Survey Methods,Surveys,Baseline Survey,Community Surveys,Methodology, Survey,Nonrespondents,Questionnaire Design,Randomized Response Technique,Repeated Rounds of Survey,Respondents,Survey Methodology,Baseline Surveys,Design, Questionnaire,Designs, Questionnaire,Methods, Survey,Questionnaire Designs,Questionnaires and Surveys,Randomized Response Techniques,Response Technique, Randomized,Response Techniques, Randomized,Survey, Baseline,Survey, Community,Surveys, Baseline,Surveys, Community,Techniques, Randomized Response
D011897 Random Allocation A process involving chance used in therapeutic trials or other research endeavor for allocating experimental subjects, human or animal, between treatment and control groups, or among treatment groups. It may also apply to experiments on inanimate objects. Randomization,Allocation, Random
D003219 Confidentiality The privacy of information and its protection against unauthorized disclosure. Patient Data Privacy,Privacy of Patient Data,Privileged Communication,Confidential Information,Secrecy,Communication, Privileged,Communications, Privileged,Data Privacy, Patient,Information, Confidential,Privacy, Patient Data,Privileged Communications
D003657 Decision Making The process of making a selective intellectual judgment when presented with several complex alternatives consisting of several variables, and usually defining a course of action or an idea. Credit Assignment,Assignment, Credit,Assignments, Credit,Credit Assignments
D003710 Demography Statistical interpretation and description of a population with reference to distribution, composition, or structure. Demographer,Demographic,Demographic and Health Survey,Population Distribution,Accounting, Demographic,Analyses, Demographic,Analyses, Multiregional,Analysis, Period,Brass Technic,Brass Technique,Demographers,Demographic Accounting,Demographic Analysis,Demographic Factor,Demographic Factors,Demographic Impact,Demographic Impacts,Demographic Survey,Demographic Surveys,Demographic and Health Surveys,Demographics,Demography, Historical,Demography, Prehistoric,Factor, Demographic,Factors, Demographic,Family Reconstitution,Historical Demography,Impact, Demographic,Impacts, Demographic,Multiregional Analysis,Period Analysis,Population Spatial Distribution,Prehistoric Demography,Reverse Survival Method,Stable Population Method,Survey, Demographic,Surveys, Demographic,Analyses, Period,Analysis, Demographic,Analysis, Multiregional,Demographic Analyses,Demographies, Historical,Demographies, Prehistoric,Distribution, Population,Distribution, Population Spatial,Distributions, Population,Distributions, Population Spatial,Family Reconstitutions,Historical Demographies,Method, Reverse Survival,Method, Stable Population,Methods, Reverse Survival,Methods, Stable Population,Multiregional Analyses,Period Analyses,Population Distributions,Population Methods, Stable,Population Spatial Distributions,Prehistoric Demographies,Reconstitution, Family,Reconstitutions, Family,Reverse Survival Methods,Spatial Distribution, Population,Spatial Distributions, Population,Stable Population Methods,Technic, Brass,Technique, Brass
D004992 Ethics, Medical The principles of professional conduct concerning the rights and duties of the physician, relations with patients and fellow practitioners, as well as actions of the physician in patient care and interpersonal relations with patient families. Medical Ethics
D005006 Ethnicity A group of people with a common cultural heritage that sets them apart from others in a variety of social relationships. Ethnic Groups,Nationality,Ethnic Group,Nationalities
D005260 Female Females

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