Alisa, 34 years old and Kenji, 32 years old, are a Japanese couple that has been together for 9 years. They are not married but have been living together and sharing a household. They are thinking to have a baby in the near future but neither of them think about getting married because they believe it is not necessary to start a family.

One day they went to a local health care center which provides free HIV tests. They did not have any concern that either of them would have a problem but thought it is good opportunity for them before having baby and also because they have had never taken the tests in the past. While waiting f or the results after tests, they filled in some information about their age, gender, marital status, health information, diet and other question. This is not for identifying who took tests so that they did not need to tell their name or address, nor other personal information that can identify the person later.

When their names were called to tell the results, they were led to different rooms separately. It was a small surprise for them because they thought they would be told the results together, so Alisa asked about that to the staff. Then the staff told them that they do not inform the results to anyone except the person who took the test and his/her spouse, even though the person who took the test agreed to have his/her partner to hear the result. If they want to know the results of their partners, they have to tell each other what they were told in the center. Eventually they followed the center's rule and heard each result separately. However this made them confused in the sense that they have to be married to hear the results of HIV tests and also they did not understand why the health care center has different attitudes towards married couples and unmarried couples.

Q1. What is behind the different attitudes of the health care centre to married and unmarried couples when the health care centers tell the results of these tests?

Q2. Should there be any policy that results of certain disease or medical tests should be informed only to the first person or limited family member(s), even though the first person agreed or wanted to have the third party with her or him?

Q3. Some couples choose not to marry but stay together just like married couples, or many young couples start living together before they marry recently. Also couples of the same gender are not allowed to marry by law in some places, though they want to. When people are in this situation, what considerations should apply in medical treatment?