A 32-year-old man was diagnosed with HIV infection 9 months ago, after presenting to a sexual health clinic for a routine sexual health screen. He attends the nursing clinic for HIV monitoring and has an undetectable viral load. You update his health history and note he is taking antiretroviral medication. You also take a sexual health history to determine if you need to offer another sexual health screen. During the sexual history interview, he tells you he has one regular female partner and casual male partners. When you ask about whether he has disclosed his HIV status to his partners, he informs you that he has disclosed his HIV status to his regular partner and is aware that as long as he has an undetectable viral load, there is no risk of sexual transmission of HIV to negative partners.  See  U=U: ASHM Guidance for Health Professionals. 

His female partner is HIV-negative; however, she is not aware he has sexual contact with men. He wants to disclose his sexuality to his female partner but is concerned about the effect it will have on his life and future.  

• What effect would an HIV disclosure without consent have on the client’s social supports and relationships?  
• How would you maintain confidentiality about the client’s sexual history if he and his partner are both attending the clinic at the same time?  
• How might your personal moral beliefs influence the care you provide?  
• What other ethical issues do you anticipate?