Abstract

This study explored psychologists' beliefs regarding the duty to maintain confidentiality and the duty to protect third parties when treating male HIV-positive patients who participate in high-risk sexual behavior without informing their partner of the seropositive status. Survey protocols were mailed to 2100 randomly selected psychologists who are members of the American Psychological Association . A total of 396 psychologists returned the completed survey. Each protocol included four hypothetical scenarios followed by statements soliciting beliefs about confidentiality, two questions requiring written responses, and a demographic questionnaire. The four hypothetical scenarios required the participants to assume their male HIV-positive patient engaged in high-risk sexual behavior without notifying the partner of the HIV diagnosis. The scenarios were identical with the exception of the patient's partner's gender and the number of partners. ;Participants responded to eight statements about confidentiality and duty to protect by rating their level of agreement or disagreement on a 7-point likert scale. Factor analysis of the hypothetical scenario statements yielded three distinct domains: willingness to breach confidentiality, partner responsibility, and decreased confidentiality as a result of intravenous drug use. The three factors comprised the dependent variables. Data were analyzed using multiple regression, analysis of variance , and t-tests. Psychologists who were more likely to maintain confidentiality were younger, lesbians or gay men, received their degree more recently, had professional HIV training, HIV consultation, experience with HIV patients, and treated a greater number of HIV-positive patients. Psychologists were more likely to maintain confidentiality when the patient was involved with multiple partners. The results suggest that decisions about confidentiality and the duty to protect are in part related to identifiable background characteristics of the psychologist who must make the decision. Implications for improving the caliber of treatment for HIV affected individuals include graduate training and continuing education. Recommendations are made for further research on the factors that influence beliefs and decisions about HIV, confidentiality, and the duty to protect