Here's a question. If a good friend told you in confidence that she was HIV positive, would you keep the secret? Or would you think of warning other people that she had a transmissible deadly virus in her blood? And would you let your children go to play at her house?
There are a good number of people who are open about their HIV-positive status. But there are also many who are not and the reason is not embarrassment at admitting to it. I visited the HIV/Aids support organisation Body and Soul a few weeks ago and was shocked at what I was told.
Some people suffer the sort of persecution one would have hoped disappeared in this country decades ago. Their neighbours turn on them, daub graffiti on their walls, shout at them in the streets and eventually drive them away. There are children who are shunned in the playground and never invited to birthday parties because they or one of their parents has HIV.
So, many of those who are HIV positive keep the knowledge to themselves. That brings a different sort of suffering, because they have nobody to turn to. Those who seek support at Body and Soul talk of it as an oasis or a sanctuary, a place where they can feel like a normal human being once again.
It is truly shocking that people can be stigmatised in this way 20 years after HIV/Aids was recognised as a problem in the UK. It should not be so, but ignorance and fear make it so. And because it is so, the question of whether a health worker who is discovered to be HIV positive should be publicly identified is not as simple as it first appears.
The Mail on Sunday has gone to court in the name of patients' rights and to fight an attempted muzzling of the press. It and other papers have been served with injunctions forbidding any identification of this health worker, his profession or his health authority. What we do know is that he is infected with the HIV virus and has treated more than 2,000 NHS and private patients.
Until the other day, Department of Health guidelines stated that all patients of any doctor, nurse or dentist who discovers he is infected with HIV must be informed. The health worker prevented the health authority from doing this by launching a legal action, claiming his right to privacy under Human Rights legislation. To the outrage of the Mail on Sunday, the DoH changed its guidelines on the eve of the hearing. Now, only patients judged to be at high risk of contracting HIV need to be told if their doctor or dentist finds he has the virus. In practice, that is going to mean only certain professions - such as surgeons - and patients exposed to certain invasive procedures.
An outrage, say the patients' organisations and the newspapers. This sort of paternalism, this covering-up for doctors and refusal to tell patients and families what is going on led to the Bristol babies and Alder Hey scandals.
But it is not that simple this time. We don't know the profession of this health worker. But suppose - to pluck two possibilities out of the air - he was a radiologist or a psychologist?
If he is either of these, he will not have been at risk of blood-to-blood contact with any of his thousands of patients. The danger he poses, in fact, is no greater than your bank manager, who will have sat down opposite thousands of customers in his time and had no more physical contact with them than a handshake.
A sense of proportion is needed here. It wouldn't be, if people with HIV were better treated in society, but as it is, this health worker's life is going to be significantly damaged if he is identified. And there may be no risk whatsoever to his patients. No, we don't feel all that happy these days leaving it up to the faceless bureaucrats in health authorities to decide whether it is appropriate to inform patients or not, but the DoH has undertaken to spell out exactly the circumstances where there is a risk and where there is not. Clearly, if a surgeon or a dentist is discovered to be HIV positive, there must be no hesitation in letting everybody know. But interestingly, one surgeon who himself went public has been allowed back to operate in Scotland - on patients who are told of his HIV status and give their consent. That's an indicator of how low the real risk is. On 22 occasions in this country, a massive look-back exercise has been mounted to trace and test all the thousands of patients of an HIV-positive health worker. Not one with the virus has been found.
Only two health workers in the world - one dentist in Florida and one surgeon in France - are thought to have ever infected patients, and in the dentist's case it is not certain how. This is a time for rational thought - not a lynch mob.
