Confidentiality is needed not only to prevent the risk of serious invasions of privacy that occur from disclosure but also as a means of controlling the AIDS epidemic by encouraging voluntary testing. A general analytical framework is presented to determine whether breaches of confidentiality for HIV-related information are appropriate in particular cases. The framework includes identifying the extent to which personal privacy and the trust essential for preserving the integrity of the professional-client relationship are implicated if confidentiality is breached and weighing the extent to which access to HIV-related information is necessary to further important interests. Given medical and social facts about AIDS, powerful reasons support strict confidentiality for HIV-related information to protect privacy and preserve trust in professional-client relationships. In some instances, important interests such as preventing physical harm to others are furthered by disclosing HIV-related information. These hard cases may ultimately require disclosure. The author suggests that notification of sexual or needle-sharing partners represents such a case and that providing discretionary disclosure by physicians to third parties in prescribed circumstances constitutes the best accommodation of conflicting values. 84 footnotes