C.Q. returns to the clinic two days later. The physician informs you that C.Q.'s Western blot test results confirm that she is HIV positive; he requests that you be present when he talks to her. Before leaving C.Q.'room, the physician requests that you give C.Q. verbal and written information about local HIV support groups and help C.Q. call a friend to accompany her home this evening. She looks at you through her tears and states, "I can't believe it. J. is the only man I've had sex with since my divorce. He told me I had nothing to worry about. I can't believe he would do this to me."
C.Q.'s statement is based on three assumptions:
(1) J. is HIV positive; (2) he intentionally withheld the information from her; and (3) he intentionally transmitted the HIV to her through unprotected sex.
Based on your knowledge of HIV infection, how would you counsel C.Q.?
• First, ask C.Q. whether she received a blood transfusion between 1978 and 1985; underwent dental
work or surgery or sustained trauma within the past several years; used a needle to inject drugs
or medications into her body (even once); got tattoos; or if she and her partner are currently using
condoms during intercourse.
• Suggest that C.Q. talk to J. about undergoing HIV testing; there is a possibility that J. is not infected
or that he is unaware that he has the HIV infection.
• Have C.Q. make an appointment with an HIV specialist to talk about her disease and undergo
further testing and workup.
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