Medico-legal aspects of STIs

The past decade has seen significant changes in the treatment of patients with sexually transmitted diseases (STIs). The introduction and developments in anti-retroviral therapy have revolutionized the treatment of HIV. While it is essential that those involved in the care and treatment of such patients keep abreast of clinical developments, it is also important to be aware of changes in legislation and professional guidance. Many of the principles that underpin good practice, such as consent and confidentiality, remain fundamentally unchanged but new legislation and updated professional guidance impose new obligations. In England and Wales, the Mental Capacity Act 2005, which came into effect in October 2007, gives statutory recognition to common law principles. The Human Tissue Act 2004, which came into effect in September 2006, regulates the storage and use of human organs and tissue from living individuals, and the removal, storage and use of human organs and tissues from the deceased. Because of these changes, the General Medical Council's guidance on Serious Communicable Diseases 1997 was withdrawn in November 2006. These changes have coincided with an increase in the number of people convicted in the UK for the reckless transmission of HIV. In this paper, I will review the medico-legal issues as they relate to the treatment of STIs and the impact of recent changes.