HIV notification of sexual contacts is an essential public health aspect of reducing transmission. This process can be challenging at times, and even more so in instances of alleged sexual assault. This article highlights the multiple complexities associated with HIV contact notification in sexual assault cases when the complainant is HIV positive, and their sexual contact (the alleged perpetrator) is in police custody. We examine ethical and legal challenges associated with a practitioner’s duty of care towards all involved parties, as well as potential issues with consent to notify sexual contact(s). Further, logistical challenges with this process, along with possible investigative implications are discussed. We contend that clinical forensic medical practitioners play a fundamental role in this context of HIV contact notification.