I'm going to make two assumptions. One is that you're in the USA.
The other is that you meant to say HIV positive. If I'm in error,
just let me know so that I can adjust the answer.
I worked in the field of mental health for 25+ years, so as far
as a bi-polar diagnosis, or that of any other mental illness, I
can tell you that a person's diagnosis are not usually disclosed
unless the client agrees to it.
Medical records, including mental health records, consist of
two aspects. The physical property of the record remains the
property of the practitioner, hospital, or other organization
which creates and maintains it. The information contained
within it legally belongs to the subject of the record.
Therefore, no one can access the records without first, the
agreement of the organization which maintains it and second,
the subject of the records.
Therefore, even the subject of the records can be denied access,
while the client is still receiving therapy, if the psychiatrist
deems it counterproductive for the client to have access. Certain
portions may be made accessible while others are withheld. I've
seen cases where even the client was not informed as to one of
his diagnoses, due to consideration of how he would likely react
if he knew. He had to file a formal request to have it disclosed
to him, and the treating psychiatrist had the option as to whether
or not to disclose the information. The doctor sought the opinions
of others involved in treatment, and it was decided not to disclose
it at that time.
As for those other than the client, family and legal access are
the usual interests. Family is normally given consideration,
but the information technically belongs to the client and is not
normally released, even to family, without an authorized release
form documenting the consent of the client. The form would include
- The name of the provider from whom the information is being
- The nature of the information authorized for disclosure
- The person(s) to whom the information is to be disclosed
- The purpose for disclosure at the time of its release
- Signature and date when signed by the client in writing
- Signature of a witness, if possible (usually a case manager)
Even if the client agrees to release information from the
medical records, while the client is still in treatment the
supervising psychiatrist may opt to limit the information
released to family, based on it being potentially counter-
Without the agreement of the client, the family can submit
a form requesting that information be released to them without
the client's consent. In that case, the practitioner carefully
weighs the clients rights and the potential benefits and/or
problems which the disclosure might entail, and would likely
question the client as to their wishes. If the practitioner
was inclined to disclose information to the family, the
practitioner would certainly attempt to get the agreement of
the client first, and might decide to abort the disclosure
if agreement was not reached.
Access by the legal system requires, in every case, a court order
to obtain the information.
One of the main reasons for this privacy is the simple fact that
the knowledge of someone's diagnosis is often a source of very
unpleasant prejudice. This is known as the "stigma" of mental
illness, and practitioners go out of their way to safeguard
their clients from this unpleasant fallout from their illness.
HIV is a very special case due to the extreme stigma involved
in disclosing the diagnosis to anyone.
This page from the Legal Explorer website goes into great depth
about the legal issues surrounding HIV, including disclosure:
"Do I have to tell my HIV status to anyone?
No. The law does not require you to disclose your HIV status
"Your HIV test is private. Generally, for another person to
lawfully reveal your HIV test results to anyone else, that
person must have your written consent to do so. However,
your signed consent is not required to disclose your HIV
test results to:
"12. Anyone with whom you had sexual contact or shared needles,
IF the disclosure is made by your doctor. This is OPTIONAL, and
not required, for your doctor, but if your doctor CHOOSES to tell,
he must do so using the HIV Partner Notification Program. However,
if you die, your doctor may inform known sexual and needle-sharing
partners directly. Consult with an attorney (see the Resources
chapter) for more information about the exceptions to HIV
Caps added for emphasis - much more on the page...
The HIV Partner Notification Program will tell a participant's
sexual and/or needle-sharing partners that they may be at risk
for HIV without disclosing the participant's identity.
This way doctors can maintain their clients confidentiality
while fulfilling the spouse's right to be informed.
From a health perspective, there are reasonable concerns that
mandatory notification of HIV test results to sexual partners
may translate into fear of HIV testing.
Naturally, if you have any suspicion that your spouse might
be positive for HIV, you can simply obtain a test for yourself.
Please do not rate this answer until you are satisfied that
the answer cannot be improved upon by way of a dialog
established through the "Request for Clarification" process.
A user's guide on this topic is on skermit-ga's site, here:
Additional information may be found from an exploration of
the links resulting from the Google searches outlined below.
Searches done, via Google:
HIV "spouse's rights"
HIV "spousal rights"
HIV "spouse's right"
HIV "mandatory notification" spouse