Many gay men and lesbians avoid government social services, partly out of a concern about confidentiality. All people, adult or juvenile, gay or straight, who enter any social service agency in North Carolina are protected to some extent by rules of confidentiality. These rules provide that no information may be disclosed to any individual not associated with that agency without a release signed by the person being served or -- and this is the big loophole -- a court order.

Lesbians and gay men who consult private practitioners may rely on the ethical codes governing physicians, psychologists, social workers and other professionals. These ethical standards prohibit professionals from revealing information given in confidence by patients or clients, except under certain circumstances. One exception is that a professional may be ordered by a court to disclose confidential information received from a patient or client. A lawyer may disclose a client's clear intention to commit a crime or a client's abuse of children, but with those two exceptions, nothing a client tells a lawyer can be disclosed, even with a court order. However, other professionals (including doctors, psychologists and others) may be ordered by a court to reveal anything, if the court believes the disclosure is necessary to the "proper administration of justice." In addition, doctors and other professionals may reveal confidential information when necessary to protect the public health or safety. Since the onset of the AIDS crisis, there have been several instances in which a doctor has revealed to a patient's employer or relatives the fact that the patient has been diagnosed with AIDS. These doctors have also revealed information about the patient's sexual practices, even though such disclosure presumably is not permitted by the law and ethical codes.

Doctors are required to report cases of syphilis and some other sexually transmitted diseases to county and state health departments. Reports of sexually transmitted disease and records of any action taken as a result of those reports cannot be disclosed to anyone outside the State or local Department of Health except where it may be necessary to prevent or control the disease. A member of a health department may only communicate in this regard with the person's sexual contacts, who are not told the name of the individual who reported them.