The New Social Worker Vol. 19, No. 3, Summer 2012 | Page 16

Social Work in an HIV/AIDS Clinic
by Joe Vanny Perez, LMSW

H

IV (Human Immunodeficiency
Virus) is a virus that destroys the
immune system. Over time, most
people with HIV become less able to fight
off the germs that surround all of us every
day, in our offices, on public transportation,
on the street, and everywhere else. These
germs usually do not make a person sick,
but when the immune system gets weaker

from HIV, these germs can cause infections
and cancers that can kill a person. There are
medications that fight HIV in the body and
help the immune system stay stronger for a
longer time. But there are no cures available
for HIV.

As a social worker for New York Presbyterian Hospital’s Center for Special Studies, I am part of a medical interdisciplinary

A Hypothetical First Session
(After introductions, I sit down with the client and
begin an initial assessment, but cannot finish because
the patient becomes upset)....
SWer: Please have a seat.
Client: (Not making eye contact) Thank you.
SWer: What brings you here today?
Client: I have not been feeling well these past few
weeks. When I tested positive, I went into severe depression. Now, I feel like my body is breaking down.
I have diarrhea, can't sleep well at night, nauseous.
SWer: How are you feeling right now?
Client: A little better. I thought you were just going
to ask me to fill out a survey or something. This is
different than what I am used to.

use a condom or not! (Client becomes tearful). It has
destroyed me!
SWer: What happened to you and him after you
tested positive for HIV?
Client: He left me. He said I cheated on him because
he was “clean.” But he is the only person I have ever
had sex with. He told me that he did not deserve to
be put at risk. He said I was a “whore” and that I
was going to die fast. Now, I am all alone.
SWer: I am so sorry to hear that. Is there anything
you could have done at that time for yourself?
Client: I should have put a condom on him. He kept
telling me “Trust me. Trust me baby. I’m clean.”
Now look at me. I’m sick. I am still in shock.

Client: Sex

SWer: You have the right to feel that way and to
be angry. It sounds like he was not honest with you
from the beginning. But, I am glad you came to our
clinic today. I am going to help you learn about our
clinic and the services we can offer you. As a social
worker, I can help you get in contact with support
in the local community including referrals to support
groups and individual therapy that can provide
you a safe space to explore what living with this
illness may mean to you. This can also give you an
opportunity to meet people who may share similar
experiences with you. Does this sound like something
that may be helpful to you?

SWer: Sex with men or women? Or both?

Client: Yeah. I am just scared. And lonely...

Client: Men

SWer: Please understand that the doctor and I are
here to support you as best we can. At this clinic,
we have a team-centered approach where we will
always make every effort to schedule you to see both
the doctor and social worker during the same visit. It
will also allow us, as your providers, to communicate easily regarding your care and provide you
with the best service possible. Feeling scared of the
unknown and lonely are two sane responses to this
traumatic life-altering journey you have been experiencing. Does this sound like something you may find
useful at this time?

SWer: Well, we do care about our patients and
make every effort to make them feel as comfortable as
possible. Would you be ok with me asking you some
personal questions?
Client: OK. Go ahead.
SWer:How were you infected? Was it through drugs
or through sex/sexual contact?

SWer: When were you diagnosed with HIV?
Client: 2006. November 2006. I remember that
night. It was snowing hard outside. I kept looking
out the window in his room thinking “how did I end
up here in his bed?”
SWer: Did the person who infected you tell you
about his HIV status beforehand?
Client: No. That is the unfair part. He should have
told me and given me the chance to decide whether to

Client: Yes. You seem to care. I appreciate it.

14

Summer 2012

The New Social Worker

team that specializes in providing medical
care to patients with HIV/AIDS.

Working with patients with HIV/
AIDS has allowed me to focus on a population that has often been neglected and
stigmatized by our society. Social stigmas,
homophobia, and lack of education have
caused many People Living With HIV/
AIDS (PLWHAs) to feel like outcasts in
their own families and communities.

As an HIV/AIDS social worker, I help
patients navigate the complicated levels of
public assistance requirements and other
hierarchal social services. I help them advocate for basic human necessities like food
and shelter and help in findi ng communitybased organizations (CBOs) that can offer
support as they come to terms with having
HIV/AIDS. I work with patients who are
undocumented from other countries, helping them secure medical care and support
to help them establish a steady foundation
in a country (the U.S.) that may be new to
them. I help lesbian, gay, bisexual, transgender, queer, and intersex (LGBTQI) patients
tackle the double stigmatization of being
treated as “different” and also living with
HIV. Sometimes culture can have a negative impact on PLWHAs and their successes
in managing the illness. Therefore, it is important that I incorporate cultural sensitivity
into my daily work with patients tackling
myths about HIV/AIDS by encouraging
learning and advocacy.

I reinforce self-care and medication adherence alongside the medical team, which
consists of a physician, nurse, psychiatrist,
and social worker. I teach patients safer
sex practices, encourage condom use, and
provide a safe and nurturing environment
that promotes healing and self-confidence.
Ultimately, I help patients regain control of
their lives through self-reflection and advocacy. Having the support of the multidisciplinary team can result in more successes,
since each team member can help reinforce
healthier lifestyles and encourage patient
ownership of individual challenges utilizing
the medical team as a foundation to build
upon.

I provide short-term therapy for patients with concerns such as being recently
diagnosed, disclosing their HIV status to
loved ones, intimate partner violence, addictions (including substance and sexual), harm
reduction, aging, and coping with grief and
loss.