# HIV Positive? As Your Therapist, I Need To Know **URL:** \ **Category:** Great Debates\ **Created:** [September 5, 2003, 9:34pm UTC](https://boards.straightdope.com/t/hiv-positive-as-your-therapist-i-need-to-know/199815 "2003-09-05T21:34:34Z")\ **Posts on this page:** 20\ **Page:** 2
**Author:** ![leechbabe](https://avatars.discourse-cdn.com/v4/letter/l/7cd45c/32.png) [@leechbabe](https://boards.straightdope.com/u/leechbabe)\ **Post date:** [September 6, 2003, 8:12am UTC](https://boards.straightdope.com/t/hiv-positive-as-your-therapist-i-need-to-know/199815/21 "2003-09-06T08:12:35Z")
> [@](#): > > \*Originally posted by Alereon \* > \*\*As a practical matter, I do think that patients should inform their caregiver of any communicable diseases they may have, as a matter of decency to a fellow human being that is putting themselves at risk for their benefit, even if they accept that risk and have the opportunity to mitigate it. I do not believe that such disclosures should be mandated by law, for the reasons I discussed above. \*\* Not only that but a caregiver is in a better position to help you if they have the full story. No point going to see a doctor about that nasty rash on your penis if you don’t tell the doc. you’ve been having unprotected sex. ---
**Author:** ![Quasimodem](https://avatars.discourse-cdn.com/v4/letter/q/e274bd/32.png) [@Quasimodem](https://boards.straightdope.com/u/Quasimodem)\ **Post date:** [September 6, 2003, 12:10pm UTC](https://boards.straightdope.com/t/hiv-positive-as-your-therapist-i-need-to-know/199815/22 "2003-09-06T12:10:16Z")
> [@](#): > > \*Originally posted by Blonde \* > \*\*You aren’t going to try to battle me for the Kate Capshaw role, are you, **j66**? 😉 > > **Quasimodem** - what do you propose in the way of new laws related to the issue? And, do caretakers really ignore the risks by not wearing protective gear? \*\* In all fairness to my profession, **Blonde** , sometimes we find out a patient is positive for a particular communicable illness only _after_ we have treated them for 2-3 days, and by then, if we’re going to contract what they have, it’s already too late. As I stated before, we can’t stay dressed out **all** the time, and therein lies the rub, so to speak. As to an earlier question, we **already** have questions built in to our basic assessment of an ER patient that determines a history of drug use, but the questions are very general in nature: “Do you drink”? “Do you use recreational drugs?” It’s a fine line that we walk, we caregivers, to be sure. And to be fair to our patients, maybe 20 years ago we cared more, but these days there are all kinds of reasons for people to abuse drugs or themselves, and it’s become more of a medical rather than a psychological issue with us: We need to keep them **alive** first! Everything else is secondary. As to new laws, I favor full disclosure. If you’ve had homosexual relations, you need to let us know. I you have used IV drugs, let us know. If you have had unprotected sex with someone you don’t know, let us know. It really doesn’t carry the stigma it did in the 60’s! What, we’re gonna **laugh** at you? **Hell** no! We want to save your life!We ( **I** ) just would not want to risk our own lives in the process! Those of us in health-care are there for a reason, and it isn’t the _money_, I can assure you of that HIPAAA is good for protective measures. We just want to make sure it doesn’t make our (caregiver’s) lives harder by hiding information we need to treat the patient. Q I guess you find out a lot about yourself in GD, huh? ---
**Author:** ![E-Sabbath](https://avatars.discourse-cdn.com/v4/letter/e/e19adc/32.png) [@E-Sabbath](https://boards.straightdope.com/u/E-Sabbath)\ **Post date:** [September 6, 2003, 12:23pm UTC](https://boards.straightdope.com/t/hiv-positive-as-your-therapist-i-need-to-know/199815/23 "2003-09-06T12:23:15Z")
> [@](#): > > \*Originally posted by Alereon \* > \*\*The only way for a caregiver to be infected with a blood-borne pathogen such as HIV is if they commit an egregious breach of safety protocols. You should be just as carefull about not sticking yourself with a needle with every patient as you are with ones you know are HIV positive. As such, it is entirely the responsibility of the caregiver to take reasonable precautions to prevent themselves from contracting a disease. > \*\* Not true. As described, a good portion of it stems from the patient. If, for example, said patient is twitching from drug withdrawl or in some other epileptic fit, despite all possible precautions, it is entirely possible to stick yourself with the needle. Life is an unending series of possible ways to screw up badly. All you can do is seek to minimize them and soldier on regardless. ---
**Author:** ![Quasimodem](https://avatars.discourse-cdn.com/v4/letter/q/e274bd/32.png) [@Quasimodem](https://boards.straightdope.com/u/Quasimodem)\ **Post date:** [September 6, 2003, 12:30pm UTC](https://boards.straightdope.com/t/hiv-positive-as-your-therapist-i-need-to-know/199815/24 "2003-09-06T12:30:22Z")
> [@](#): > > \*Originally posted by E-Sabbath \* > \*\* Life is an unending series of possible ways to screw up badly. All you can do is seek to minimize them and soldier on regardless. \*\* Well said. Thank you. Q ---
**Author:** ![Blonde](https://avatars.discourse-cdn.com/v4/letter/b/3be4f8/32.png) [@Blonde](https://boards.straightdope.com/u/Blonde)\ **Post date:** [September 6, 2003, 2:45pm UTC](https://boards.straightdope.com/t/hiv-positive-as-your-therapist-i-need-to-know/199815/25 "2003-09-06T14:45:44Z")
> [@](#): > > \*Originally posted by Scylla \* > \*\*Hi. I was told there was going to be punch and pie here. \*\* Would you settle for donuts and beer? 😉 ---
**Author:** ![Quasimodem](https://avatars.discourse-cdn.com/v4/letter/q/e274bd/32.png) [@Quasimodem](https://boards.straightdope.com/u/Quasimodem)\ **Post date:** [September 6, 2003, 3:02pm UTC](https://boards.straightdope.com/t/hiv-positive-as-your-therapist-i-need-to-know/199815/26 "2003-09-06T15:02:41Z")
’ Lo **Blonde**. You have _Pie_? 😉 Q ---
**Author:** ![Syntropy](https://avatars.discourse-cdn.com/v4/letter/s/65b543/32.png) [@Syntropy](https://boards.straightdope.com/u/Syntropy)\ **Post date:** [September 6, 2003, 5:57pm UTC](https://boards.straightdope.com/t/hiv-positive-as-your-therapist-i-need-to-know/199815/27 "2003-09-06T17:57:06Z")
> [@](#): > > \*Originally posted by Alereon \* > **In the real world, healthcare professionals are, at times, going to decide that they just don’t want to bother with full precautions. When you do this, YOU TAKE YOUR LIFE INTO YOUR HANDS. You fully accept the risks that the patient you are seeing MAY have a communicable disease, and that if you screw up, YOU MAY DIE. It’s just the same as sleeping around without a condom, it’s your risk to take, but you can’t say you didn’t know the risks and the consequences if it bites you in the ass.** I’m sorry, just how effective do you believe latex is against a scalpel? Or a needle? Or patients that bite & scratch? In a trauma hospital, (which are becoming scarcer, btw) with a busy ER on a Friday night, short staffed, how much warning do you believe these people have? I cannot count the number of times I heard “Inbound, eta 2 minutes…” and then scramble whatever trauma team you can from whatever it is they’re doing. Barely time to get the room cleared and ready, not NEARLY enough time to get geared up. Especially considering you are getting report from an EMT on the run, trying to assess the situation. Yes, the risk is there. I’m so sorry, but this guy is bleeding to death. I’m dealing with THAT right now, thanks awfully. As I’m trying to save his life, the least he can do is let me know he is a danger to mine. ---
**Author:** ![Guinastasia](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/guinastasia/32/5751_2.png) [@Guinastasia](https://boards.straightdope.com/u/Guinastasia)\ **Post date:** [September 6, 2003, 6:32pm UTC](https://boards.straightdope.com/t/hiv-positive-as-your-therapist-i-need-to-know/199815/28 "2003-09-06T18:32:37Z")
Apparently, our buddy **Alereon** has never watched _ER_. ---
**Author:** ![Syntropy](https://avatars.discourse-cdn.com/v4/letter/s/65b543/32.png) [@Syntropy](https://boards.straightdope.com/u/Syntropy)\ **Post date:** [September 6, 2003, 6:34pm UTC](https://boards.straightdope.com/t/hiv-positive-as-your-therapist-i-need-to-know/199815/29 "2003-09-06T18:34:50Z")
We can only hope. As Quasi can probably tell you, it ain’t all that realistic… ---
**Author:** ![Blonde](https://avatars.discourse-cdn.com/v4/letter/b/3be4f8/32.png) [@Blonde](https://boards.straightdope.com/u/Blonde)\ **Post date:** [September 6, 2003, 7:17pm UTC](https://boards.straightdope.com/t/hiv-positive-as-your-therapist-i-need-to-know/199815/30 "2003-09-06T19:17:13Z")
I’ll agree 100% with **Guinastasia** and **Maureen** - picture yourself hosing down the back of an ambulance after someone bled/pissed/threw up everywhere. Do you really think there’s no chance you’ll be infected?? Quasi, I’ve got lemon ice-box pie. Make an offer! ---
**Author:** ![Quasimodem](https://avatars.discourse-cdn.com/v4/letter/q/e274bd/32.png) [@Quasimodem](https://boards.straightdope.com/u/Quasimodem)\ **Post date:** [September 6, 2003, 7:56pm UTC](https://boards.straightdope.com/t/hiv-positive-as-your-therapist-i-need-to-know/199815/31 "2003-09-06T19:56:45Z")
We plunge right on in. A life is a life. Everything else is secondary. That is how it _should_ be, but sometimes we don’t get to ask those questions. We are ABC trained. **Airway** **Breathing** **Circulation** Q ---
**Author:** ![dropzone](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/dropzone/32/7515_2.png) [@dropzone](https://boards.straightdope.com/u/dropzone)\ **Post date:** [September 7, 2003, 2:31am UTC](https://boards.straightdope.com/t/hiv-positive-as-your-therapist-i-need-to-know/199815/32 "2003-09-07T02:31:36Z")
> [@](#): > > \*Originally posted by leechbabe \* > **You’d think so wouldn’t you but I’ve worked with some of very uncareful people** Yeah, I was sleepy and tolerant and assuming the best of people based on my experience with my very careful wife. Then I logged off, went back to one of my virus books, and read about some lab guys dying from monkey herpes after handling the alive and very awake monkeys without wearing their heavy, leather gloves. Real Darwin Award material. :smack: I swear, I will never assume the best of people again. ---
**Author:** ![j666](https://avatars.discourse-cdn.com/v4/letter/j/9de0a6/32.png) [@j666](https://boards.straightdope.com/u/j666)\ **Post date:** [September 7, 2003, 2:55am UTC](https://boards.straightdope.com/t/hiv-positive-as-your-therapist-i-need-to-know/199815/33 "2003-09-07T02:55:37Z")
> [@](#): > > \*Originally posted by Guinastasia \* > \*\ ***j66** , your right to privacy ends when my life is in immediate danger, I believe? \*\* That is just a hijack; AIDS does NOT but your life in immediate danger. And that law applied only to medical professionals. Back to the main point, Q: um, isn’t the rates AIDS infections increasing with heterosexuals, and not homosexuals? Oh, that is my real problem with AIDS awareness for health professionals; I think the policies are homophobic, and based on decades old data. All bad temper aside, I don’t think disclosure WILL make health care professional safer. ---
**Author:** ![Alereon](https://avatars.discourse-cdn.com/v4/letter/a/ecd19e/32.png) [@Alereon](https://boards.straightdope.com/u/Alereon)\ **Post date:** [September 7, 2003, 5:26am UTC](https://boards.straightdope.com/t/hiv-positive-as-your-therapist-i-need-to-know/199815/34 "2003-09-07T05:26:50Z")
Again, if you follow proper safety protocols, you’re at no greater risk of being infected with a blood-borne pathogen if you don’t know your patient is infected than if you know they ARE infected. If you’re NOT following proper safety protocols, then you’re taking your life into your hands, fully appreciating possible consequences of your actions and your responsibility for these consequences. **Blonde** : What would you do if you knew the blood was HIV infected? That’s what you should be doing anyway. **Maureen** : How exactly is knowing your patient has HIV going to save you from a needle stick trying to give them an injection during a seizure? The risk is unchanged. As for being unable to glove up before treating a patient, well, that’s your job. If you feel you are being put at unacceptable personal risk, QUIT. If you feel the money isn’t good enough considering the hazards, QUIT. You KNOW what the dangers are going into the situation, what you do with that information is your choice. **Quasimodem** : The particulars of a patients life, if unrelated to current treatment, are none of your business. If they ARE related, you are perfectly justified in asking, and informing the patient of the consequences of failing to answer truthfully. However, if I come in because I got stabbed in the arm, my recreational drug use, sexual orientation, and past activities are not relevent. If I have HIV, yes, it would just be common decency to warn you. However, you should ASSUME that I have some icky pathogen regardless and take appropriate precautions. If you don’t, that’s your decision, but the consequences of this decision are your responsibility. ---
**Author:** ![Alereon](https://avatars.discourse-cdn.com/v4/letter/a/ecd19e/32.png) [@Alereon](https://boards.straightdope.com/u/Alereon)\ **Post date:** [September 7, 2003, 5:40am UTC](https://boards.straightdope.com/t/hiv-positive-as-your-therapist-i-need-to-know/199815/35 "2003-09-07T05:40:52Z")
Clarification: I greatly respect the job that healthcare professionals do. However, when you take a job as a caregiver, you do so with the knowledge that there is a risk that you will be exposed to life-threatening diseases. This risk goes with the job, and is risk you voluntarily assumed when you became a caregiver. If the risk wasn’t acceptable to you, you shouldn’t have taken the job. ---
**Author:** ![Quasimodem](https://avatars.discourse-cdn.com/v4/letter/q/e274bd/32.png) [@Quasimodem](https://boards.straightdope.com/u/Quasimodem)\ **Post date:** [September 10, 2003, 3:12am UTC](https://boards.straightdope.com/t/hiv-positive-as-your-therapist-i-need-to-know/199815/36 "2003-09-10T03:12:58Z")
Whether the policies are homophobic is a matter of opionion and one not shared by me. If I gave the impression of a homophobe, it was not intended and I want to make it clear that I care for my patients _equally_ regardless of sexual orientation. Thanks to all of you who responded. Maybe I’m getting the hang of this debate thing? 😉 Q ---
**Author:** ![Blonde](https://avatars.discourse-cdn.com/v4/letter/b/3be4f8/32.png) [@Blonde](https://boards.straightdope.com/u/Blonde)\ **Post date:** [September 10, 2003, 3:31am UTC](https://boards.straightdope.com/t/hiv-positive-as-your-therapist-i-need-to-know/199815/37 "2003-09-10T03:31:35Z")
Wow. How could **Quasimodem’s** original question be construed as homophobic - **Alereon** I believe you’re responding in a hostile manner to this topic, and perhaps you should reconsider your post. ---
**Author:** ![Alereon](https://avatars.discourse-cdn.com/v4/letter/a/ecd19e/32.png) [@Alereon](https://boards.straightdope.com/u/Alereon)\ **Post date:** [September 10, 2003, 4:59am UTC](https://boards.straightdope.com/t/hiv-positive-as-your-therapist-i-need-to-know/199815/38 "2003-09-10T04:59:51Z")
> [@](#): > > \*Originally posted by Quasimodem \* > **As to new laws, I favor full disclosure. If you’ve had homosexual relations, you need to let us know. I you have used IV drugs, let us know. If you have had unprotected sex with someone you don’t know, let us know.** That’s the relevent passage there, **Blonde**. Look, I didn’t call anyone a homophobe, in word or in meaning. I DO think that **Quasimodem** ’s statement contains an element of homophobia, since that’s what we call treating gay people like they are disease-ridden. Howabout in the future, you just say “all people who have engaged in high-risk behaviors?” Just being gay doesn’t count. Then no one is insulted or offended, and we don’t have a problem. Back to the point of this thread, there’s no reason for you to need that information. In most cases it doesn’t help you treat the patient, and it doesn’t keep you more safe. Thus, it’s none of your business. If IS necessary to treatment, sure, go for it. Otherwise, again, it’s none of your business, any more than a random guy on the street can walk up to people and ask about their sexual activities. ---
**Author:** ![E-Sabbath](https://avatars.discourse-cdn.com/v4/letter/e/e19adc/32.png) [@E-Sabbath](https://boards.straightdope.com/u/E-Sabbath)\ **Post date:** [September 10, 2003, 9:54am UTC](https://boards.straightdope.com/t/hiv-positive-as-your-therapist-i-need-to-know/199815/39 "2003-09-10T09:54:35Z")
Reads more like a Red Cross statement on donating blood. “If you’ve been to Belgium, let me know.” ---
**Author:** ![Quasimodem](https://avatars.discourse-cdn.com/v4/letter/q/e274bd/32.png) [@Quasimodem](https://boards.straightdope.com/u/Quasimodem)\ **Post date:** [September 11, 2003, 1:37am UTC](https://boards.straightdope.com/t/hiv-positive-as-your-therapist-i-need-to-know/199815/40 "2003-09-11T01:37:50Z")
Okay, I wasn’t going to post anymore to this thread because I felt I had made my point, but some of you have brought up some things that I just cannot argue with, and so I would just like to say yes, I **know** a person’s lifestyle isn’t any of my business, but I have had instances where I’ve been stuck and had to go through AIDS testing myself and it’s not a lot of fun. Some of the patients were elderly and not a risk factor, but I still had to go through it because they jumped and I stuck myself with the needle. Thankfully, it doesn’t happen often, but a needle’s going to go into you no matter what precautions you take. Lastly, I want to just say that I do not believe myself to be a homophobe. I may have worded some of my introductory and follow-up remarks badly, but it might just be that I’m a 53 year “Old Fogey”. 😃 I also like **Alereon’s** suggestion about the questioning about “high-risk behaviors”. It’s just that the question may be countered with _another_ question (_“What are you talking about?!”_), and then I would have to get specific. Anyway, thanks Y’all! Whether you agreed or disagreed, I paid attention, and I will remember. Q [Previous page](https://boards.straightdope.com/t/hiv-positive-as-your-therapist-i-need-to-know/199815.md?page=1) [Next page](https://boards.straightdope.com/t/hiv-positive-as-your-therapist-i-need-to-know/199815.md?page=3)