Notifying contacts of HIV-infected patients

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Although transmission of human immunodeficiency virus (HIV) can be deadly, few states have laws requiring that a physician report the infection. Not until the infection progresses to acquired immunodeficiency syndrome (AIDS) do clear federal and state reporting laws apply. However, an HIV-infected patient who refuses to discontinue high-risk activities represents a danger to others. Physicians caring for these patients may have a duty to warn the patient's contacts about methods of transmission and risk of infection. The authors provide practical guidelines for coping with the conflicting responsibilities and duties to the patient and to others.