a. Need for Confidentiality. As a health care provider, you have a
responsibility to keep the knowledge that an individual has AIDS, ARC, or an HIV
infection confidential. In the military, do not talk about cases of individuals with any of
these infections. You will need to follow standard operating procedures for reporting
such information as you come across it in your job. Currently, government policy
affecting people with AIDS, ARC and/or HIV infection is as follows:
(1) All military personnel and all recruits are tested for HIV antibodies. Army
recruits, ROTC students, service academy cadets, and all candidates for officer service
are expelled if found to be infected with HIV. Active duty personnel who test positive for
HIV are not separated from the service but are subject to involuntary change and limited
duties.
(2) In regard to AIDS, ARC, and/or HIV infection, there is a limited
confidentiality. Information a military doctor learns from his military patient may be used
against the patient in court-martial proceedings. Care will be taken that only those with
a "need to know" are given any information about a soldier's HIV status. For example,
the HIV-infected soldier will be advised to inform all previous sexual partners to seek
testing and counseling. Information must also be reported to civilian public health
authorities.
NOTE:
In the civilian community, all states have laws requiring that doctors report the
identities of individuals diagnosed with AIDS either to state or local health
authorities. For many years, doctors have been required to report other
communicable and sexually transmissible diseases. Through the years, \
public health officials have a good record of keeping such information
confidential. The purpose of reporting such AIDS information is to help track
the progress of the AIDS epidemic.
b. Feelings of the Patient at the Time of Diagnosis. Generally, individuals
first diagnosed as having AIDS experience these reactions: fear and panic, denial,
anger and depression, and helplessness. Most individuals pass through theses phases
of feelings in the sequence given here. Naturally, not everyone reacts this way. Let's
look at these feelings, since these are the most common reactions.
(1) Fear and panic. Since there is much about this disease that is unknown,
it is natural and normal to be afraid and to panic. There have been many horror stories
about this disease. Additionally, the prospect is that the disease is fatal. Specific fears
may include fear of rejection, fear of being helpless and alone, fear of pain, and, of
course, fear of death.
(2) Denial. First, the thoughts are "It can't be me." "Oh, no, not me." That
the person could have the disease seems just too horrible to be true.
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