Social work can be a rewarding career field, allowing you to earn a living while helping those in need. When working with clients who are HIV-positive, however, certain ethical dilemmas can arise. These dilemmas can be based on laws concerning the confidentiality of an individual's HIV status or prejudice resulting from incorrect assumptions and misinformation about HIV. Education and consideration of the client's best interests are key in dealing with these ethical dilemmas.
Confidentiality
An individual's HIV status is confidential and protected by law. Revealing the HIV status of an individual without her express consent can lead to lawsuits for breaching confidentiality, disciplinary action being taken against you by your employer or your state's licensing board, and potentially serious damage to your credibility as a social worker. To avoid breaching confidentiality discuss your client's HIV status with individuals only if you have received written permission from to do so.
Discrimination
HIV-positive individuals are protected against discrimination by the Americans with Disabilities Act. Additionally, the code of ethics for the National Association of Social Workers specifically states that social workers should not discriminate or facilitate discrimination based physical disability such as HIV infection. The NASW asks social workers to assist in dispelling myths and stereotypes about HIV, increase awareness of the disease, and to be proactive in bringing about change and ending discrimination against those infected with HIV.
Care Assistance
HIV treatment is expensive, and the doctor visits and medical decisions that must be made concerning treatment can be exhausting and stressful. Decisions must be made on when to start treatment, after which the often harsh side effects of medications must be dealt with. This care must be coordinated so that HIV-positive individuals receive the medical care they need and any necessary financial assistance to cover what they cannot afford. Psychological therapy or support groups may also be needed to help the client to cope with his HIV status. Ethical dilemmas may arise when trying to determine the best course of treatment or finding that needed treatment isn't readily available, especially when trying to procure services such as housing assistance in areas where lengthy waiting lists exist.
Duty to Warn
Though confidentiality is an important part of working with HIV-positive clients, social workers also have an obligation to prevent their clients from doing harm to others. If a client with HIV is knowingly putting another at risk through unprotected sex or intravenous drug use and has no intention of revealing his HIV status, you may have a duty to warn the individual if you have attempted to get your client to warn his sexual partner and he has repeatedly refused. Consult colleagues and legal aid before breaching confidentiality; do so without revealing the client's identity if possible.
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