title: Management of HIV-positive psychiatric patients who fail to reduce high-risk behaviors.
abstract: 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.
authors.affiliation: Department of Psychiatry, Veterans Administration Medical Center, Minneapolis, Minnesota 55417.
authors.forename: G A
authors.initials: GA
authors.lastname: Carlson
authors.forename: M
authors.initials: M
authors.lastname: Greeman
authors.forename: T A
authors.initials: TA
authors.lastname: McClellan
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000150:complications / Q000523:psychology* / Q000635:transmission; D000328:Adult; D032763:Behavior Control; D003134:Commitment of Persons with Psychiatric Disorders / Q000331:legislation & jurisprudence; D003617:Dangerous Behavior; D003866:Depressive Disorder / Q000523:psychology; D006679:HIV Seropositivity / Q000150:complications / Q000523:psychology* / Q000635:transmission; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000150:complications / Q000523:psychology*; D028642:Persons with Psychiatric Disorders; D008910:Minnesota; D010349:Patient Compliance; D012307:Risk Factors; D012803:Sick Role; D013406:Suicide, Attempted / Q000523:psychology; D014754:Violence