and implicit actions, by the person concerned. Coded or implicit actions may include disclosure that
allows for the communication of a person’s health status in a manner other than direct verbal
dialogue. States must ensure that all forms of disclosure are recognised.
19. While disclosure should be encouraged, there should be no requirement to reveal one’s HIV
status or other information related to one’s health status. In the context of HIV, healthcare workers
should be authorised, without being obliged to, decide, depending on the nature of the case and
according to ethical considerations, whether to inform a patient’s sexual partners of his or her HIV
positive status. Such a decision should be made in line with international standards, in accordance
with the following principles:[5]
i. The HIV-positive person in question has been thoroughly counselled;
ii. Counselling of the HIV-positive person has failed to achieve appropriate behavioural changes;
iii. The HIV-positive person has refused to notify, or consent to the notification of his/her partner(s);
iv. A real risk of HIV transmission to the partner(s) exists;
v. The HIV positive person is given reasonable advance notice;
vi. The identity of the person is not revealed to the partner (s), if practicable, otherwise identity is
revealed;
vii. Follow-up is provided to ensure support to those involved, as necessary; and
viii. The person providing HIV treatment, care, or counselling services has ensured that the person
living with HIV is not at risk of physical violence resulting from the notification.
The revealing of a person’s health status by a third party outside the ambit of the above mentioned
guidelines is unlawful and may lead to penal sanctions.
General State Obligations: Respect, protect, promote and fulfil
20. Article 14 (1) (d) and (e), like any other human rights provision, imposes four sets of general
obligations on States Parties namely to respect, protect, promote and fulfil.
21. The obligation to respect in relation to Article 14 (1) (d) & (e) requires States to refrain from
interfering directly or indirectly with the rights to self-protection, to be protected, and the right to be
informed on one’s health status and the health status of one’s partner.
2 2 . The obligation to protect in relation to Article 14 (1) (d) and (e) requires States to take
measures that prevent third parties from interfering with these rights. Special attention, in the
implementation of this obligation, should be given to action by third parties that may impact on the
right to sexual and reproductive health of all women, including those mentioned under paragraph
14 above.
23. The obligation to promote in relation to Article 14 (1) (d) and (e) requires States to create the
legal, social and economic conditions that enable women to exercise their rights in relation to
sexual and reproductive health. This involves engaging in sensitisation activities, community
mobilisation, training of healthcare workers, religious, traditional and political leaders on the
importance of the right to protection and to be informed on one’s status and that of one’s partner.
24. The obligation to fulfil in relation to Article 14 (1) (d) and (e) requires States to adopt all the
necessary measures, including allocation of adequate resources for the full realisation of the right
to self-protection and to be protected and the right to be informed on one’s health status and the
health status of one’s partner.
Specific State Obligations
25. The right to self-protection and to be protected against sexually transmitted infections, including
HIV in Article 14 (1) (d) of the Protocol entails the following: