Potential Responses to a Client with HIV/AIDS

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Sexually transmitted infections (STIs), and HIV/AIDS in particular, are physical health conditions that can have a profound impact on a client’s psychological and relationship functioning. For example, a psychological impact may be that the client feels shame or guilt for having acquired the infection. An example of a relationship impact may be that a client’s disclosing to his or her partner that he or she has the infection may lead to suspicion or mistrust within the couple’s relationship.
Helping professionals also may hold certain biases and assumptions or have particular emotional responses to clients with STIs, specifically HIV/AIDS. These may relate to the client’s prognosis for meeting treatment goals, the helping professional’s level of hope for the client to have a satisfying life, and/or stereotypes about how these infections are acquired. Left unexamined, these biases, assumptions, and emotional reactions can impact a helping professional’s ability to work effectively with a client with an STI, including HIV/AIDS.
Respond by to your colleagues’ postings, sharing or validating an insight gained from your reading using your professional experiences.
Potential Responses to a Client with HIV/AIDS
Socially held stigmas associate a diagnosis of HIV or AIDS with promiscuity, extramarital sex, or other undesirable, censured behavior (Centers for Disease Control and Prevention [CDC], 2022a). The Centers for Disease Control and Prevention (2022b) recommend that people with HIV/AIDS take steps to protect others by choosing sexual activities that are less risky than vaginal or anal intercourse, using appropriate protective barriers and disclosing their status to partners. When a client reveals that they have HIV or AIDS, a helping professional can respond with empathy or with judgment and stigmatized attitudes (Golin et al., 2010).
Professionals responding judgmentally may conceptualize behavior as ‘good’ or ‘bad’ and make moral judgments about clients based on the types of behavior in which a client engages (Golin et al., 2010). Due to their stigmatized attitudes, professionals responding judgmentally may believe clients internalize stigmas about individuals with HIV/AIDS and that the diagnosis causes them to experience shame and embarrassment. According to Horan (2015), individuals with higher numbers of sexual partners are less comfortable talking about safe sex practices. A judgmental professional may think that the diagnosis does not impact that person’s relationships because they do not disclose the information to potential partners. Some providers believe health issues become more important than issues related to sexuality when a person has a serious illness (Levine et al., 2016). A professional with stigmatizing, judgmental beliefs may think that the impacts that a diagnosis of HIV or AIDS has on a person’s intimate relationships do not matter to them.
A provider responding to a client with HIV or AIDS empathetically respects their client’s autonomy and self-determination and recognizes that each person’s experience is unique (Golin et al., 2010). They understand that clients have a choice in what they disclose and the types of sexual activity in which they participate and may choose to use motivational interviewing techniques to explore the psychological and relational impact of the diagnosis (Golin et al., 2010). A diagnosis of HIV or AIDS is a traumatic, stressful, life-changing event that may cause a person to think differently about themselves or become depressed (CDC, 2022a). With that said, the trauma of diagnosis and illness can be long-lasting; providers can work with patients to process the grief associated with the diagnosis and associated life changes (Levine et al., 2016). However, participants in a study conducted by Golin et al. (2010) suggested that people with HIV or AIDS can feel otherwise; they suggested images in a safer sex training course be more visible and appear less embarrassed. Changes in sexual functioning or an inability to engage in previously enjoyed sexual activities can cause feelings of loss and sadness and impact relationship dynamics (Levine et al., 2016). When a couple no longer participates in the sexual activities they once did, other relationship issues can become heightened; however, the relationship does not have to be destroyed (Levine et al., 2016). Different types of sexual activities can satisfy needs for emotional and physical intimacy (Levine et al., 2016). Similarly, psychotherapeutic interventions and enhancing affectionate communication can improve relationship dynamics (Horan, 2015).
Centers for Disease Control and Prevention. (2022a, June 2). Facts about hiv stigma.
Centers for Disease Control and Prevention. (2022b, June 9). Protecting others.
Golin, C. E., Davis, R. A., Przybyla, S. M., Fowler, B., Parker, S., Earp, J., Quinlivan, E., Kalichman, S. C., Patel, S. N., & Grodensky, C. A. (2010). Safetalk, a multicomponent, motivational interviewing-based, safer sex counseling program for people living with hiv/aids: A qualitative assessment of patients’ views. AIDS Patient Care and STDs, 24(4), 237–245.
Horan, S. M. (2015). Further understanding sexual communication. Journal of Social and Personal Relationships, 33(4), 449–468.
Levine, S. B., Risen, C. B., & Althof, S. E. (Eds.). (2016). Handbook of clinical sexuality for mental health professionals (3rd ed.). Routledge

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