Factors affecting social workers\u27 decision to breach confidentiality of HIV -positive clients in order to warn third parties

The present study examined factors affecting social workers\u27 decision to breach HIV-positive clients\u27 confidentiality in order to warn third parties. Perceived client dangerousness, one of the main criteria established under the Tarasoff ruling, and homophobic attitudes were both examined as contributing factors. Additional personal and professional traits of social workers, such as experience working with HIV-positive clients, age, ethnicity, gender, ethics training, years of practice, and having an HIV-positive family member, were also examined. A cross-sectional study, using a self-administered survey questionnaire was used. The sample consisted of 274 members of the National Association of Social Workers New York City Chapter who were living in New York City in January, 1999. Study results validate the hypothesis that the greater the degree of perceived client dangerousness, the more likely social workers are to breach HIV-positive clients\u27 confidentiality in order to warn third parties. The findings also confirm that the less experience social workers have working with HIV-positive clients, the more likely they are to breach the confidentiality of HIV-positive clients who are perceived as highly dangerous. The fewer years of practice social workers have was also found to be a predictor of an increased likelihood of breaching the confidentiality of HIV-positive clients who are perceived as highly dangerous. No significance was found for the influence of homophobic attitudes in decision-making. Overall, the findings indicate that perception of clients as highly dangerous is an overriding factor for an increased likelihood of breaching HIV-positive clients\u27 confidentiality. Results are discussed with implications for social work education and practice