Privacy and confidentiality are essential for all aspects of patient care�history-taking, examination, education and counselling. This is especially true for potentially stigmatizing conditions such as STI/RTI. All patients have a right to privacy and confidential services, but some�such as adolescents, sex workers, refugees and others who live or work in illegal or marginalized settings�may feel a particular need to know that services are confidential. Adolescents, especially those who are unmarried, often do not use services because they feel providers will be judgemental or disapproving and might reveal information to parents or elders. Patients will avoid a health care facility altogether�sometimes travelling to a distant clinic to preserve anonymity�if they feel that their privacy and confidentiality are not respected or that service providers are critical and judgemental.

Making space for privacy

Assuring visual and auditory privacy and confidentiality can be difficult in many health care settings, especially those that are busy or crowded�but it is essential. The space where interviews, examinations and counselling take place should be separated from waiting rooms, so that people waiting cannot see or hear what takes place between the provider and the patient. Forms and records should be stored securely and clinic staff should avoid talking about patients both inside and outside the clinic. Patients should be treated with the same respect whether or not an STI is detected or suspected, and regardless of age or marital status. Where health care providers are likely to know patients� extended families or neighbours, they must take extra care to reassure patients (and their partners who may be asked to come in for treatment) that confidentiality will be respected.