PSY699: Master of Arts in Psychology Capstone
Week Five Discussion Case File
Case Summary Client: Victoria, 16-year-old HIV positive Latina
Consultation and suggested course of action regarding disclosure of Victoria’s HIV positive
status was received 4 years ago. Clinic decision was to honor mother’s request that HIV status not
be disclosed to her daughter Victoria, who was then 12 years old.
Current issue: Victoria is now 16 years old and has a boyfriend. Victoria has explained to her
physician at the clinic that she and her boyfriend are sexually active and do not always use
condoms. Victoria is unaware that she is HIV positive because of her mother’s insistence on non-
disclosure. The physician has not broken Victoria’s confidentiality about sexual activity, but has
expressed to her mother, Tina, that it is time for Victoria to know her diagnosis. This is based on
Victoria’s age, the statistics that many girls are sexually active at this age, and that Victoria could
endanger her partner(s). Tina continues to object to disclosure. She states Victoria’s regular
church attendance and her belief that Victoria will remain abstinent until marriage as evidence for
The staff is again wrestling with whether or not they should inform Victoria that she is HIV
positive. In doing so, they would enable her to make informed decisions about exposing her
boyfriend to the sexual transmission of HIV. However, her legal guardian (her mother Tina) does
not wish for this information to be disclosed to Victoria, who may still be considered a minor.
The clinic staff is concerned as this situation presents several ethical dilemmas and requires
Previous Case Summary (from 4 years ago) Client 1: Tina, a 36-year-old HIV-positive Latina woman
Client 2: Tina’s daughter, 12-year-old Victoria (also HIV positive)
Tina became infected through a former boyfriend who had a history of intravenous drug use.
Tina gave birth to an HIV-positive daughter, Victoria. Tina does not want Victoria to know that
either of them has HIV.
Victoria is now 12 years old and has been told by her mother that she takes medications for “a
problem in her blood.” Recently, Victoria stated that she does not like taking the medication and
occasionally misses doses. The clinic staff has raised the issue of whether Victoria should be told
about her diagnosis. They’ve warned Tina that in the near future, Victoria will be at an age at
which girls often become more interested in boys or sexual behavior. The clinic’s therapist feels
that if Victoria knew her diagnosis she might be more adherent to her regimen of medications.
However, Tina absolutely does not want her daughter to know. Tina believes Victoria is still too
young and will be emotionally devastated. Tina believes that it is her responsibility — and only
her responsibility as a mother — to “protect” her child, and that her daughter is “not ready” to
know. Tina also believes that Victoria is “a good girl” and will not be sexually active until she is
The clinic’s therapist thinks Tina’s guilt about having transmitted the virus to her daughter is
causing her to take this stance. Still, the clinic staff is concerned and wants Tina to reconsider.
This situation presents several ethical dilemmas and requires further consultation.