Chapter 6: Psychological and Social Challenges of Living with HIVAIDS

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Chapter 6Psychological and Social Challenges of
Living with HIV/AIDS
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Psychological and Social Challenges of Living
with HIV/AIDS

• People living with HIV/AIDS face unique
  psychological and social challenges
• from HIV disease itself
• from anti-HIV treatment
• from HIV/AIDS-related stress and uncertainty
• from grieving the loss of HIV loved ones
• as well as stigma and discrimination

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HIV/AIDS-Related Psychological Disorders

• HIV and opportunistic diseases can alter a
  persons brain and nervous system, causing
  psychological disorders
• Psychological disorders associated with HIV
  include
• HIV-associated dementia (HAD)
• Minor cognitive-motor disorder (MCMD)
• Mood disorders, like depression
• Anxiety disorders
• Brain tumors
• Opportunistic infections of the brain and nervous
  system

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Other HIV/AIDS-Related Psychological Concerns

• Psychological side effects of anti-HIV drugs
• These can range from moodiness and aggressive
  behavior to severe depression, suicidal thoughts,
  paranoia, delusions, and hallucinations
• HIV/AIDS-related psychological distress
• Chronic physical pain
• Physical disfigurement
• Possibility of infecting other people
• Changes to lifestyle to accommodate illness and
• financial burdens of treatment
• Possible discrimination, abuse, and loss of human
  rights
• Guilt about burdening friends and family
• Loss of independence
• Physical, social, and emotional isolation
• Uncertainty in the medical, personal, and social
  domains
• Hopelessness, frustration, and self-blame related
  to not responding to treatment

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Meeting the Psychological Needs of Persons Living
with HIV/AIDS

• HAART gives hope and optimism to HIV people,
  which improves physical health, decreases
  depression, and prolongs life span
• Providing psychological services for HIV persons
  helps the general public as well, as high levels
  of depression and maladaptive coping with HIV
  infection have been associated with substance use
  and risky sexual behavior, which puts others at
  risk for acquiring HIV
• The stress of HIV/AIDS can be buffered by the
  social support provided by support groups
• Coping and stress management programs positively
  affect the mental health of people living with
  HIV/AIDS

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Living with the Uncertainties of HIV/AIDS

• People who live with HIV/AIDS often face
  uncertainty.
• Such uncertainty is stressful and can impair HIV
  peoples quality of life

• Medical Uncertainties
• Not enough information about diagnoses
• Ambiguous symptoms
• Complex and uncertain treatment
• Unpredictable disease progression or prognosis
• Personal Uncertainties
• Identity dilemmas

• Financial Uncertainties
• Claiming disability status
• Amount of money for needed for treatment is
  unknown
• Social Uncertainties
• Unpredictable interpersonal reactions
• Unclear relational implications

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HIV/AIDS-Related Grief

• Most people living with HIV/AIDS have lost
  someone to HIV disease
• As a result, HIV people commonly have high
  levels of HIV/AIDS loss-related psychological
  distress
• Coping with a loss due to HIV/AIDS may differ
  from coping with losses to other diseases in
  several ways

• Many people who die from complications of HIV
  disease die at a relatively young age
• The stigma associated with HIV may prevent those
  who survive from freely mourning or acknowledging
  the cause of death
• In the United States, HIV has been highly
  concentrated within specific populations. People
  in these communities have lost many to HIV/AIDS
  and have watched their social networks dwindle
• Survivors guilt may prevent those who have
  lost loved-ones from fully grieving and recovering

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Community-Based Responses to HIV Loss

• The
• AIDS
• Memorial
• Quilt

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HIV/AIDS-Related Stigma and Discrimination

• HIV/AIDS is one of the most stigmatizing medical
  conditions in modern history
• Many communities direct unfavorable attitudes,
  beliefs, and policies toward people who have or
  who are associated with HIV/AIDS, including their
  loved-ones, family members, close associates, and
  social groups

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Effects of HIV/AIDS-Related Stigma and
Discrimination

• HIV/AIDS-related stigma affects HIV/AIDS
  diagnosis and treatment
• Many people are hesitant to find out their
  serostatus, or to seek treatment for HIV disease

• The stigma of HIV/AIDS is combined for many with
  the stigma of homosexuality and illicit drug use
• Fear of discrimination may compel men who have
  sex with men to keep their sexual behavior secret
  and deny their sexual risk
• Stigma from drug use restricts effective HIV/AIDS
  prevention and treatment