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Knowing a pt has HIV or AIDS...
Aug 8, 2004

Is it ethical and should i ask an imcoming patient if they have AIDS or a possibility of having been exposed ( AIDS screening ) for a short term inpatient stay in a co-ed unit setting for mental health and detox? As a professional caring for the client do i really need to know? Please forgive me if you are duplicating a response here, i didn't see a post quite like this one....

Response from Ms. Breuer

This is an important question with at least two angles. I'm glad you wrote.

First, the key question to ask yourself about knowing an incoming patient's HIV status is "What would I do differently?" If your infection control procedures are in place, the response should be "Nothing." So you don't need to know from a safety point of view. I trust that, by now, your facility has a policy of treating all human blood as if it were infectious. Since the facility is co-ed, I assume you also have policies in place about sexual conduct on the part of patients. Policies that respect the health and treatment plans of all residents should reflect awareness of high rates of sexually transmitted disease in the mental health patient population. With those policies in place and in practice, there is no need to ask.

But there is another aspect to this, more directly tied to treatment. Since the rate of HIV infection is high among those who suffer from mental illness or need detox services, your intake interview could ask a few general questions that would alert a therapist to follow up with a conversation about HIV. You are in a position to help identify people who may be positive and not be aware of it, so you could ask a few questions about HIV testing and the person's knowledge of HIV transmission. That is different from asking for the person's HIV status or sexual history. Before there is trust, such questions are premature. But knowledge/testing history questions probably are appropriate. Helping an HIV-positive person enter treatment for HIV (if that is the decision the person makes) could be a life-extending aspect of treatment at your facility.



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