Reasons given by patients for "non-progression' in HIV infection

Psychosocial profile and lived experience of HIV-infected long-term nonprogressors: a mixed method study

The goal of this mixed method study was to describe the psychosocial profile of HIV-infected persons identified as long-term nonprogressors (LTNP), and their experiences of nonprogression. Data were collected from 24 participants with a mean age of 48 years and a mean duration of infection of 14 years. Results show rather moderate levels of anxiety and depression symptoms and a modest mean score of social support. Participants adapted by using acceptance, positive restructuring, and active coping strategies. Seven themes marked the experience: (a) reacting to announcement and dealing with diagnosis, (b) valuing interpersonal relations and well-being, (c) making changes in life, (d) coping with stress, (e) dealing with health care, (f) beliefs about reasons for nonprogression, and (g) living positively while dreading progression. The findings enrich a field of knowledge that has had little attention so far and shed light on the psychosocial profile of LTNP and their experiences of nonprogression.

Is AIDS chronic or terminal? The perceptions of persons living with AIDS and their informal support partners

Viewed as a terminal disease just a decade ago, HIV/AIDS is now often characterized as a chronic yet manageable disease. The goal of this study is to assess the perceptions of the course of the disease among persons living with AIDS and their informal support partners and to identify the themes that distinguish the differing perceptions of the epidemic. The findings from this research reveal that 41% of persons living with AIDS and 39% of their informal support partners perceive AIDS as chronic. By contrast, 37% of persons living with AIDS and 39% of the informal support partners perceive AIDS to be terminal rather than chronic. Among persons living with HIV/AIDS, those with lower levels of education and higher levels of perceived race-based discrimination were significantly more likely to view AIDS as a terminal rather than chronic condition. In addition, informal support partners in poor health were significantly more likely than others to view AIDS as terminal rather than chronic. Content analyses of the qualitative data revealed five broad themes related to the specific perceptions of AIDS, including medications, personal experience, cure, time/eventuality and education. The implications of these findings are discussed.

If I didn't have HIV, I'd be dead now: illness narratives of drug users living with HIV/AIDS

The purpose of this study is to illuminate the experiences of lower income, urban, HIV-positive drug users. The authors asked 60 participants about HIV risk behaviors, the impact of HIV on their lives, religious beliefs, life plans, relationships, and work-related issues both prior to and since diagnosis. They developed a theoretical framework based on illness narratives and ambiguous loss theories. Themes pertaining to both physical and emotional or spiritual dimensions were located within Benefit, Loss, or Status Quo orientations. The findings contribute to researchers' understanding of the HIV/AIDS illness experiences among the very marginalized and have important implications for physical and mental health care professionals working with HIV-positive drug users.

Complementary therapy use in HIV/AIDS

OBJECTIVE

To examine the social psychological aspects of complementary therapy use in HIV/AIDS health care and to identify what happens in a person's illness management process when incorporated into their care for HIV-related symptoms.

METHODS

Grounded theory research method guided sampling, data collection and analysis with 21 males at various AIDS service organizations.

FINDINGS

A grounded theory model Finding a Way to Live was developed. Participants experienced a six-stage process whereby the HIV served as a precondition for a profound self-transformation; a commitment to and rediscovery of the meaning of life. Complementary therapies, referred to as 'tools' by the participants, were cited as an integral part of how people living with HIV found wellness within their illness. The type of therapy, meanings attached to them, intention for and frequency of use corresponded to where individuals were in the six-stage process. As participants began to experience personal growth, the nature of the therapies shifted from those being highly tangible and focusing on the physical self to those facilitating inner awareness, such as meditation.

CONCLUSIONS

The process of integration was a complex, ongoing process wherein complementary therapies were an integral part of facilitating learning, self-discovery and ultimately, healing.

Challenges associated with increased survival among parents living with HIV

OBJECTIVES

This study examined sociodemographic and psychosocial factors that predict survival among parents living with HIV.

METHODS

Parents with HIV (n = 307) were recruited from 1993 to 1995 in New York City and repeatedly assessed. Survival was monitored among the sample (81% mothers; 45% Latino, 34% African American).

RESULTS

Over a median period of 28 months (range = 0-53 months), 44% (n = 135) of the parents died. Having an AIDS diagnosis and being African American were associated with earlier death. Sex, age, and financial status were not related to survival. Parents who survived had initially higher levels of anxiety that decreased over time; in contrast, parents who died reported initially lower, but constant, levels of anxiety over time. After HIV diagnostic status was controlled for, it was found that parents who reported having more children, using a coping style of seeking social support, and being sexually active at baseline survived longer.

CONCLUSIONS

The counterintuitive findings raise hypotheses regarding the role of change and responsibilities in the survival of parents with HIV.

Long-term nonprogressors with HIV disease

BACKGROUND

Although biomedical research is being conducted on long-term nonprogressors with HIV disease, there is relatively little research on the psychosocial factors influencing this phenomenon.

OBJECTIVE

To describe the perceptions of long-term nonprogressors of their HIV disease and its course.

METHOD

A naturalistic study design was used to elicit information from 25 men and women who were long-term nonprogressors (HIV positive for 7 or more years, CD4 count > 500, and free of opportunistic infections and/or AIDS-defining illnesses). Audiotaped interviews were transcribed verbatim, and content analysis and constant comparison were used to elicit themes.

RESULTS

Themes include viewing HIV as a manageable illness, taking care of my physical health, human connectedness, taking care of my emotional/mental health, and spirituality. Specific ways of adapting to HIV are identified within each theme.

CONCLUSIONS

The results of this study can be used by nurses who work with HIV positive individuals in an effort to help them adopt strategies that may assist them in maintaining their health. However, longitudinal studies that follow this group over time and that include biomedical markers of disease progression would provide knowledge that would assist in the refinement of these interventions.