2. HIV & AIDS
• HIV
Human Immunodeficiency Virus
• AIDS
Acquired Immune Deficiency Syndrome
2
3. The legal definition of AIDS
• When a person’s T-cell count goes below 200,
he/she is considered as having AIDS.
3
4. Three primary types of contact that can
result in transmission of HIV
• Sexual contact, that is, contact with infected
genital secretions (semen, vaginal fluids,
menstrual blood)
• Injection of infected blood through
transfusions or needle sharing
• Pregnancy in an infected mother
4
5. Transmission that is not biological
possible
• Shaking hands
• Sharing a toilet
• Sharing eating utensils
• Being sneezed upon
• Living in the same household
• Working in the same room or attending the same
classroom
• Closed-mouth kissing
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6. Social stigmatization
• HIV disease, in particular, carries with it the social
stigmatization that complicates mental health
and threatens life-sustaining activities.
“Telling friends I’m HIV positive is not the same as
telling them I’m gay”—double coming out, the
first closet and the second closet
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7. Ethics issues related to HIV &
AIDS
• Disclosure
• Disability rights
• Economical resources
• Employment rights
• Medication & Treatments
• Suicide
• Duty to warn
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8. Disclosure
• To tell or not?
Decisions whether to disclose the diagnosis in
the workplace.
• A doctor with HIV needs not to disclose?
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9. Disability Rights
• Disability rights awareness
e.g., “Somehow a check-out person at a local
grocery store found out I had AIDS and started
wearing latex gloves every time she waited on
me. I called their legal department and
informed them that this needed to stop or I
would sue them”
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10. Economical resources
• Financing treatment
e.g., “Medicare doesn’t pay for my
prescriptions anymore.”
Different kind and degree of services than a
person who is employed and who has health
insurance and other resources available.
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11. Employment
• Can they decide whether to stay in their
current position or not?
e.g., “My old job as a nursing assistant was too
high risk, so I had to leave.”
Emotionally missing work
e.g., “Work had always been important to me
and it really hit me all at once that I wasn’t
able to do it anymore.”
11
12. Medication & Treatments
• Dissatisfactory with the treatment providers
e.g., “A lot of times I’m not in the mood to talk
with the doctors in the clinic. They don’t listen
and they are very clinical.”
12
13. Medication & Treatments contd.
• Treatment effects
e.g., “I had a very bad reaction to the drug I
was taking and had to go back into the
hospital”
13
14. Suicide: the dilemma of the right
to die
• High suicidal rate
the relative risk of suicide in men with AIDS aged 20-
59 years was 36.30 times…that of men aged 20-59
years without this diagnosis. (New York City, 1988)
• Seven people during a 6-week period took their own
lives after testing positive for the virus, even though
they were asymptomatic
(Miami, 1987)
14
15. Is there a legal duty to protect or
warn third parties
• Whether a therapist has a duty to protect
third parties when his or her patient, if HIV-
positive, persists in engaging in unprotected
sex with an unknowing partner involves
complex clinical and legal questions which
have not been adequately addressed.
15
16. Counselor’s guide to make an
ethical decision
• Moral Principles
• Ethical decision making model
16
17. Moral principles
• Autonomy: individual freedom and choice
• Nonmaleficence: do no harm to clients
• Beneficence: the welfare of the clients
• Justice: If an individual is to be treated
differently, the counselors needs to offer a
rationale that explains
• Fidelity: loyalty, faithfulness and honoring
commitments
17
18. Ethical decision making model
1. Identify the Problem
2. Apply the ACA Code of Ethics
3. Determine the nature and dimensions of the
dilemma
4. Generate potential consequences of all
options and determine a course of action
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19. Contd.
5. Consider the potential consequences of
all options and determine a cause of
action.
6. Evaluate the selected course of action.
7. Implement the course of action.
19
20. Counseling implications
• Counselors require to be knowledgeable
about federal, state, and local laws.
Especially when illegal treatment in the
workplace takes place, counselors advocate
for clients who have encountered
discrimination
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21. About disclosure,
counselors can…
• Help clients identify the risks and benefits
they are likely to encounter by disclosing their
illness.
• Help clients explore concerns associated with
the fear of disclosure, living with
nondisclosure.
21
22. About the treatment issues,
counselors can/may
• May find their clients feeling overwhelmed
with their medical treatment, medical
personnel, and health care systems.
• Can help clients to cope with emotional
reactions to their illness and to interpersonal
insensitivity from medical care providers.
22
23. Risk reduction counseling is
suggested
• Safer sex practice
• No needle sharing
• Avoid pregnancy
23
24. References
Bartlett, J.G. (1991). The Guide to Living with HIV Infection,
Baltimore: The John Hopkins Press.
Forester-Miller, H. & Davis, T. (1996). A
practitioner’s guide to ethical decision making.,
http://aca.convio.net/site/PageServer?pagename=resources_
prac_guide
Gaughan, D.M. (2004). Psychiatric Hospitalizations Among
Children and Youths with Human Immunodeficiency Virus
Infection. Pediatrics, vol.113, e544-e551.
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25. Reference Contd.
Hunt, B., Jaques, J., Niles. S. G., & Wierzalis E. (2003). Career
concern for people living with HIV/AIDS. Journal of
Counseling & Development, 81, 55-81.
Klitzman, R. (1997). Being Positive. Chicago: Ivan R.
Dee.
Pope, K.S. () New Research, Ethical Responsibilities, Evolving
Legal Frameworks & Published Resources.,
http://kspope.com/ethics/aids-hiv.php
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