Tuberculosis and AIDS: the impact on the hospital social worker

The second decade of the AIDS epidemic is marked by increasing numbers of people being diagnosed with HIV infection as well as mycobacterium infection (pulmonary tuberculosis). The convergence of these two epidemics presents new challenges for social workers. Serious threat of HIV infection from occupational exposure was diminished by the knowledge of roots of disease transmission. TB, on the other hand, is an airborne infectious disease. Social workers working with patients over long periods of time in confined spaces can be at risk for contracting TB. Hospital social workers must struggle and advocate for full information regarding the incidence of risk and risk precaution. They must find ways of coping with their own emotional responses to the resurgence of TB and their own fear of exposure to avoid physical and emotional withdrawal from their HIV infected patients. This paper will address the unique impact on the worker's personal safety, the impact on the therapeutic relationship with the patient, and provide action steps for workers facing these challenges.