Ethical Challenges in the Applications of Motivational Interviewing in HIV Care

This chapter engages with ethical challenges of using motivational interviewing (MI) and MI-based interventions in HIV care. We first outline two general ethical worries in respect of MI use. We argue that the relational and technical components of MI provide insufficient ethical action guidance and ethical safeguards respectively. It is necessary to consider factors external to the method of MI in order to establish the ethical permissibility of its applications. We subsequently consider the ethics of MI in the context of HIV care, specifically in relation to pre-exposure prophylaxis, medication adherence, and disclosure of HIV/AIDS diagnosis/prognosis. Our framework for discussion of these specific issues may be relevant to other applications of MI in HIV care.