Having the Conversation

This is not the ideal response based on the information provided. This response crosses ethical boundaries when it comes to working with clients. This client’s partner is engaging in risky behaviors by sharing injection equipment, which presents a risk of contracting HIV. Although your client is not injecting, they are at risk by having unprotected sex with someone who is using non-sterile equipment.

This is the ideal answer. This client, although not injecting themselves, is at risk of HIV due to having unprotected sex with someone who is sharing injection equipment. Should their partner use a needle that a person living with HIV used, the partner and your client are now both at risk of contracting HIV. Encouraging the client to begin PrEP can protect them from situations like this.

This is not the ideal response based on the information provided. You can protect your client, but you ultimately cannot make their partner change a behavior. Helping the client recognize the risky behaviors they and their partner are engaging in could lead to them starting PrEP.

This is the ideal response. In this situation, providing him with education about HIV is a great way to start breaking down stigma. Once he understands that people living with HIV still lead happy and healthy lives, providing education about PrEP can be helpful for John to start the conversation with those close to him.

This is not the ideal response. While abstaining from sex will minimize the risk of spreading HIV, this is not the ideal immediate response. Many people that are living with HIV live healthy sex lives, often with people are not living with HIV. Instead, explaining ART and viral suppression can help destigmatize the process and encourage the client to begin treatment.

This is not the ideal response. Probing for information in this way may cause your client to disengage from treatment. We want to refrain from making any assumptions or asking potentially judgmental questions unless absolutely necessary. In this case, knowing how the client contracted HIV does not impact his care moving forward.

This is not the ideal response. The PrEP medications Truvada and Apretude are both approved for women. Instead, providing education about PrEP for women can start to decrease some stigma Sharon may be experiencing.

This is not the ideal response. In this situation, discontinuing care on the basis of a client not beginning PrEP is not appropriate. Every individual can choose to start or stop taking a medication, but providing education about PrEP can work against the misinformation she is currently expressing.

This is the ideal response. Explaining that Truvada and Apretude are approved for women, and providing some educational material about PrEP for women, can give Sharon the tools she needs to feel comfortable asking her doctor for PrEP.