Keeping secrets: social workers and AIDS

The current epidemic of human immunodeficiency virus infection and acquired immune deficiency syndrome (AIDS) poses major ethical issues for the profession of social work, as it does for the rest of society. Although social work clearly is establishing a body of literature about the psychosocial issues surrounding AIDS, much less attention has been paid to the particular moral problems that social workers face in their day-to-day practices with people with AIDS. To begin to examine the most relevant and salient moral problems that social workers experience in their practices, 16 social workers were interviewed. The dominant moral theme that was identified was secrecy. The theme of secrecy is analyzed according to four dimensions: (1) ethical, (2) technical, (3) behavioral, and (4) existential. The clarification and justification of the use of secrecy in social work practice with people with AIDS is discussed.