Carlson G A, Greeman M, McClellan T A
Department of Psychiatry, Veterans Administration Medical Center, Minneapolis, Minnesota 55417.
Hosp Community Psychiatry. 1989 May;40(5):511-4. doi: 10.1176/ps.40.5.511.
The authors describe clinical and legal dilemmas faced by staff involved in providing inpatient psychiatric treatment to two HIV carriers who continued to practice high-risk behaviors after learning of their HIV infection. Staff were unsure of their obligation to report the patients under a state law giving the commissioner of health broad discretion to limit the freedoms of HIV-infected individuals who continue to practice high-risk behaviors. Treatment of the patients also raised concerns about the appropriateness of treating noncompliant HIV-infected patients in traditional psychiatric settings and the lack of suitable aftercare facilities. The authors advocate developing a specialized treatment approach for noncompliant HIV-infected patients and provide a series of recommendations that might serve as the foundation for such an effort.
作者描述了为两名艾滋病毒携带者提供住院精神治疗的工作人员所面临的临床和法律困境。这两名携带者在得知自己感染艾滋病毒后仍继续从事高风险行为。根据一项州法律，卫生专员被赋予广泛的自由裁量权，可限制那些继续从事高风险行为的艾滋病毒感染者的自由，工作人员不确定他们是否有义务报告这些患者。对这些患者的治疗还引发了对在传统精神科环境中治疗不依从的艾滋病毒感染者的适当性以及缺乏合适的后续护理设施的担忧。作者主张为不依从的艾滋病毒感染者制定专门的治疗方法，并提供了一系列建议，这些建议可能成为此类努力的基础。
