Discrimination

December 2023

My GP referred me to a physiotherapist for neck pain and prescribed dry needling, a stimulation of trigger points with needles, among other things. At the first consultation, I was surprised when she asked me about my HIV infection. She said she couldn't treat me with needles because of a possible risk of transmission, even though I pointed out that I had had an undetectable viral load for years. What is the legal situation?

Dr Caroline Suter answers

Your GP apparently mentioned your HIV diagnosis in the referral to the physiotherapist. As the HIV infection is a secondary diagnosis that has no factual connection with the treatment of the cervical spine, it should not have been mentioned in the referral without your express consent. This constitutes a breach of data protection. The fact that both the doctor and the physiotherapist are subject to a duty of confidentiality cannot justify the transfer of data. The duty of confidentiality also applies if the recipient of the information is themselves subject to professional secrecy. It is not a specific group of people who are obliged to maintain confidentiality, but the individual person. Draw your doctor's attention to this data protection issue and ask him/her not to disclose your HIV diagnosis in future without your express consent if the referral is not related to HIV.

The duty of confidentiality also applies if the recipient of the information
is himself subject to professional confidentiality.

Unfortunately, many people, including those in the medical field, are not yet sufficiently aware that they are not infectious if their HIV treatment is successful. However, whether someone has an undetectable viral load or not is irrelevant in this case. The therapist must take hygiene measures regardless of whether she knows the HIV status of a person or not. This applies all the more as it must be borne in mind that there may always be an as yet unknown blood-borne disease - both on the part of the patient and the therapist. Accordingly, the Swiss guidelines for safe dry needling, published by the Swiss Dry Needling Association, point out that it must always be assumed that every person is potentially infectious. For this reason, appropriate hygiene measures must be taken during all treatments.

Even if the physiotherapist is only legally obliged to provide treatment in emergencies, her behaviour is discriminatory, as there are no objective reasons against carrying out the needle treatment. Such discrimination is particularly serious in an environment that should be characterised by trust. We recommend that you confront the physiotherapist and draw her attention to the discrimination. The legal counselling service of the Swiss AIDS Federation will be happy to assist you. It is also possible for the legal team of the Swiss AIDS Federation to contact the physiotherapist on your behalf and inform her about the legal situation.

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