Bernice K. Lopez
ANG 7704
Ethics Assignment
02/28/2013
Jane Doe, RN, is a prior graduate of an applied anthropology program and currently serves as an administrative research coordinator at a newly established clinic for underserved and at-risk youth. Jane has overseen and managed numerous projects with this population over the years; however, it is her current research within the field of HIV prevention where she faces both a test of her personal morals and of her professional ethics. She is currently working on a project that identifies Latino/Hispanic men-who have sex-with men (MSM) and their social networks and brings them in for HIV testing. Per the CDC, young people in the U.S. are at great risk for HIV infection, with young people aged 13-29 accounting for all new HIV infections in 2009 (CDC, 2012). This risk is particularly disproportionate amongst young gay, bisexual, and other (MSM), especially young African American or Latino MSM, and all youth of minority races and ethnicities (CDC, 2012). Thus, continual identification of risky-behaviors and HIV prevention outreach and education efforts are needed. Jane is in charge of establishing such efforts and besides participant recruitment for her project, also provides testing, linkage to care and teaches prevention strategies through promoting abstinence and condom-use. Jane faces an ethical dilemma that lies within a particular case of a boy named John, who is an African-American, gay adolescent that tested positive when recruited for the project. She has maintained a rapport with John, who is often out in the area in which the majority of her recruitment is conducted from and who comes to her place of work where his linkage of care is provided. Therefore, Jane has had ample opportunities to stress the importance of adhering to medications and taking care of his body. Additionally, she has counseled John on the importance of utilizing prevention strategies—mainly the use of condoms--and has provided condom-negotiation tips; preferably, she says it is best to inform all current sex-partners regarding his status. She has also stressed the need for John to inform previous sex partners regarding his status and their need to come in and get tested for HIV. She says John always listened intently. However, like any adolescent, she did not expect him to follow everything she told him. And thus, she found out later that he had not. While seeing and admitting other HIV+ adolescents to care, Jane keeps noticing a particular pattern that all her new patients have in common when asked about their sexual history: John was, or currently is, a sexual partner. When asked if condom-use was negotiated or if any partners informed them that they had an STI or HIV prior to the occurrence of sexual activity, a majority of patients replied, ‘No’. Though there were other sexual partners, reported by these new patients, Jane is sure that John is the initial infector for all cases. The next time John comes, in Jane talks to him regarding condom use and informing his current partners. He proclaims that it is not his responsibility to negotiate condom-use and that a majority of his sexual partners “do not want to use a condom anyway”. He also states that he does not disclose his status to partners for fear that they will “spread it all over the community” and then, no one will want to have sex with him. Though Jane understands the stigma that comes with being HIV positive, she emphasizes again the importance of the aforementioned factors; John only appeases her with responding with, “I’ll try”. Two weeks ago several more patients came in to the clinic to receive care, one of which tested positive. John was identified as a partner. Jane is at odds with what to do. In order to prevent further spread of HIV, her own morals tell her to inform all future project participants, especially those within John’s social network, that he is positive. She also wants to prevent reinfection to