Legal standards for HIV testing are evolving in an attempt to achieve an ethical equilibrium between the privacy rights of infected or potentially infected individuals and public health considerations that seek to limit the spread and severity of the disease through early recognition and treatment. Although guided by US Centers for Disease Control and Prevention recommendations, these standards are determined by state law. In this case, an ethical dilemma is presented and discussed in which the privacy interests of an HIV-infected individual come into conflict with the health considerations of an inadvertently exposed neurology resident and her unborn child, a conundrum amplified by the restricted HIV testing laws of the state in which the incident took place.