Table of Contents
Introduction
Currently, HIV status disclosure has become an epidemic as many HIV positive individuals choose to keep their status secretly due to the fear of discrimination and stigma. As a result, health caregivers have been faced with ethically complex situations in trying to encourage parents and HIV infected individuals to disclose their HIV status.
How American Psychological Association (APA) Ethical Principles and Code of Conduct Can Be Used to Guide Decisions in an Ethically Complex Situation
The APA ethical principles can only be used by psychologists in their scientific, professional or educational roles. The American Psychological Association (2018) shows that in an ethically complex situation such as the case of Victoria’s HIV disclosure, the Ethics Code can be used to provide guidance and the principles of the professional code of conduct to psychologists. Particularly, in the process of developing decisions psychologists must take into account the Ethical code, the applicable laws and the psychology board regulations.
Whether the Staff Should Encourage the Daughter to Inform Her Mother that She is Sexually Active
Following the case of Victoria, a 16-year-old Positive Latina, the clinic staff need to encourage Victoria to inform her mother that she is sexually active. In addition, psychologists focus on protecting the welfare and rights of those they relate with professionally and the affected persons (American Psychological Association, 2018). Therefore, by encouraging Victoria to inform her mother about being sexually active, the staff will be safeguarding the welfare of both the daughter and her partner. This will prevent the transmission of HIV/AIDS. Besides, the staff should inspire the patient to update her mother about her sexual involvement due to the fact that, the APA Code of Conduct requires that psychologists should take reasonable actions in order to minimize harm where it is predictable and unavoidable.
Whether Mother’s Knowledge Regarding Her Daughter’s Sexual Activity Influence the Mother’s Stance Regarding Disclosure
While disclosure can be linked with greater adherence to HIV care and enhancement in both mental and physical health, the mother’s knowledge concerning her daughter’s sexual activity would not possibly influence the mother’s stance about non-disclosure of Victoria’s HIV status. This is because the mother intents to protect her daughter who is a minor as lack of disclosure is associated with fear of suffering stigmatizing beliefs about HIV from persons, risk behavior, and discrimination (Clum et al. 2013).
Explaining Whether the Staff Should Break Confidentiality and Inform the Mother About Her Daughter Being Sexually Active
To facilitate the treatment and prevention of Victoria’s illness and spread of HIV, the staff should break the patient confidentiality and inform the mother about the daughter’s involvement in sexual activities. According to Obermeyer et al. (2011), while an ethical dilemma might result from the confidentiality of patient information and the need to inform those living with the patients, it is important to prevent the spread of risks. That is, if the respect for confidentiality increases health risks to third parties, then routine third-party disclosure may help reduce the damages. This shows how managing the ethical dilemma is a critical challenge among health workers.
Whether the Staff Should Encourage the Mother to Inform the Daughter of Both Her and Her Daughter’s HIV status
The APA (2018) exemplifies the fact that APA principle of human relations calls for psychologists to take sound decisions that can help reduce harm where it is foreseeable and inevitable. Therefore, the staff should encourage the mother to disclose both her and her HIV status since HIV disclosure is believed to a successful HIV prevention strategy and a timely disease management initiative (Eustace & Ilagan, 2010). Furthermore, the process of HIV disclosure has antecedents and consequences that may include disease acceptance, desire to protect others and attain support and personal, familial, and community factors. Most importantly, a previous study shows that HIV disclosure to adolescents by caregivers resulted to greater social and academic support for the young individuals, while disclosure through rumor triggered discrimination and stigma (Gillard & Roark, 2013).
The Rights of Victoria’s Boyfriend
Considering the fact that Victoria has been involved in sexual activities with her boyfriend, the boyfriend has the rights to HIV disclosure. Additionally, both the staff and Victoria’s mother has a moral obligation of notifying her daughter’s partner of the HIV status of her daughter. Obermeyer et al. (2011) claims that the right of sexual partners to be informed of their partner’s status and be protected is as fundamental as the privacy of patients suffering from HIV/AIDS. Moreover, the boyfriend has a right to therapeutic counselling.
Whether the Mother Has the Right Not to Disclose the Diagnosis of Her Daughter
Although HIV disclosure is perceived to be challenging for HIV-positive parents, Victoria’s mother has no right not to disclose the diagnosis of her daughter at the age of 16. This is because children have the right to age-fitting information regarding their status and should not establish that they are positive through rumors. Despite the fact that parents and healthcare providers continue to disagree on the timing and appropriateness of disclosure, adolescents need to be informed of their HIV status early enough in order to prevent transmission and develop a management initiative (Eustace & Ilagan, 2010).
The Right to Privacy of the Mother
Just like any individual living with HIV, Victoria’s mother has the right to privacy concerning her own diagnosis. Demonstrate that the privacy of people living with HIV/AIDS (PLWHA) is as fundamental as the right to disclose to partners of their HIV status. To minimize intrusions of patient’s privacy, psychologists should discuss confidential information attained in their work only for professional uses and with individuals that relate with the matters (APA, 2018). Most importantly, psychologists can only disclose confidential information with proper consent from the individual patient or from legally authorized individual acting on behalf of the patient.
Approaches that Can Be Taken by the Staff in HIV Disclosure
Leonard et al. (2010) established that a computer-based intervention that provides peer modeling of disclosure scenarios will help improve the effectiveness of HIV disclosure. That is the approach could help regulate and strengthen risk reduction messages. In particular, since the HIV-positive adolescents fear being stigmatized, the computer-based interventions can assist in addressing privacy and confidentiality issues.
Eustace and Ilagan (2010) recommend that an approach that safeguards individual and public rights should be developed by the staff to reflect better the diversity and variability of the HIV disclosure process among HIV-positive persons. Provision of services that support PLWHA such as counselling services is an important approach that will enhance HIV disclosure particularly, between patients and health caregivers (Obermeyer et al. 2011). Additionally, Horvath et al. (2011) shows that a law that a law that criminalizes HIV-positive individuals who engage in unprotected sex without disclosure of their status to their partners can be adopted.
If Further Information is Required to Develop an Ethically Sound Course of Action
To develop an ethically sound course of action and help patients make informed choices, further information is needed. For instance, information on conceptual clarity is useful in developing enhanced HIV disclosure measures since the information offers an expanded theoretical definition and realization of attributes of HIV disclosure (Eustace & Ilagan, 2010). In addition, during the HIV disclosure process, the caregivers should provide adolescents with important information regarding the prevention of secondary HIV transmission (Leonard et al.). Patients should avail crucial information to both health and family caregivers in order to secure suitable medical care.
Conclusion
To conclude, it’s evident that HIV disclosure is difficult causing people to keep their HIV status secret. Failure of disclosure has been associated with stigma and discrimination. Therefore, important services need that support PLWHA such as provision of counselling need to be implemented in order to enhance the HIV disclosure processes.
We can do it today.
- American Psychological Association (2018). Ethical Principles of Psychologists and Code of Conduct: Including 2010 and 2016 Amendments
- Clum, G.A., Czaplicki, L., Andrinopoulos, K., Muessig, K., Hamvas, L., Ellen, J.M., &the Adolescent Medicine Trials Network for HIV/AIDS Interventions. (2013). Strategies and outcomes of HIV status disclosure in HIV-positive young women with abuse histories. Aids Patient Care and STDs, 27(3), 191-200
- Eustace, R.W. & Ilagan, P.R. (2010). HIV disclosure among HIV positive individuals: a concept analysis. Journal of Advanced Nursing, 66(9), 2094-2103
- Gillard, A. & Roark, M.F. (2013). Older adolescents’ self-determined motivations to disclose their HIV status. Journal of Child and Family Studies, 22(5), 672-683.
- Horvath, K.J., Weinmeyer, R., & Rosser, S. (2011). Should it be illegal for HIV-positive persons to have unprotected sex without disclosure? An examination of attitudes among U.S. men who have sex with men and the impact of state law. AIDS Care, 22(10), 1221-1228
- Leonard, A.D., Markham, C.M., Bui, T., Shegog, R. &Paul, M.E. (2010). Lowering the risk of HIV-positive transmission: insights from a HIV-positive youth and healthcare providers. Perspectives On Sexual Reproductive Health, 42(2), 110-116
- Obermeyer, C.M., Baijal, P. & Pegurri, E. (2011). Facilitating HIV disclosure across diverse settings: a review. American Journal of Public Health, 101(6), 1011-1023