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HIV, Confidentiality, and Duty to Protect

Considerations for Psychotherapists in the Age of Treatment as Prevention


Confidentiality and duty to protect are complex issues for psychotherapists treating clients with HIV. The application of the Tarasoff ruling to situations involving HIV has long been debated with questions about how the Tarasoff principles of identifiability of the victim, foreseeability of harm, and necessary protective action apply to HIV within the context of psychotherapeutic relationships. The complexity of these debates is compounded by advances in HIV medicine including the availability of antiretroviral therapy and pre- and postexposure prophylaxis in addition to the current state of knowledge about treatment as prevention. The purpose of this article is to revisit Chenneville’s (2000) decision-making model on HIV, confidentiality, and duty to protect in the age of pre- and postexposure prophylaxis and antiretroviral therapy. This revised model may serve as a critical framework for psychotherapists providing services to clients with HIV.

Dr. Chenneville is the Marie E. and E. Leslie Cole Endowed Chair in Ethics and Professor and Chair of Psychology at the University of South Florida (USF) St. Petersburg. She also holds a Joint Appointment in the USF Department of Pediatrics where she serves as a Behavioral Health Consultant for the Pediatric and Adolescent Infectious Disease Program. Dr. Chenneville’s primary program of research is in the area of pediatric and adolescent HIV with a focus on the psychosocial issues affecting children and youth living with perinatally or behaviorally acquired HIV. Dr. Chenneville prioritizes issues related to ethics with a particular emphasis on the decisional capacity of children with HIV to participate in treatment and research along with global research ethics. She also engages in community-based participatory research on HIV-related stigma among youth. Because HIV is a global disease, Dr. Chenneville is interested in cross-cultural research. She has collaborated with colleagues in India and has been working on the HIV SEERs Project (Stigma-reduction through Education, Empowerment, and Research) in Kenya since 2015. She also is collaborating with colleagues in the UK as well as South Africa where she worked as a Fulbright Specialist in the Perinatal HIV Research Unit of the University of Witwatersrand. Dr. Chenneville has contributed significantly to the literature with dozens of peer-reviewed journal articles and book chapters. In 2017, she published an edited book with Springer Publishing, A Clinical Guide to Pediatric HIV: Bridging the Gaps between Research and Practice. Dr. Chenneville’s contributions have been recognized through many awards and honors including the USF World Global Achievement Faculty Award for International Research, the USF Faculty Outstanding Research Award, the Women in Leadership and Philanthropy Award, the USF Outstanding Faculty Award, and the USFSP Chancellors Awards for Excellence in Research, Teaching, Service, and Global Engagement.

Cite This Article

Chenneville, T., & Gabbidon, K. (2020). HIV, confidentiality, and duty to protect: Considerations for psychotherapists in the age of treatment as prevention. Psychotherapy, 57(1), 7-14.



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