Identity Issues for People Living with HIV/AIDS: Humans with Potential or Sexual Victims?

Sexuality issues are important to consider within the practice of occupational therapy. This is especially so when working with people with the human immunodeficiency virus and the acquired immune deficiency syndrome (HIV/AIDS), where issues related to sexuality are both relevant and present. Recent advances in HIV medications have improved the health and life expectancy for many people living with HIV/AIDS (PLWHA). This has been not only a medical and biological change, but also one that has had dramatic impact on the psychosocial issues, including those related to sexuality, relevant for PLWHA.

This shift in HIV context prompted the creation of a new occupational therapy service for PLWHA — Positive Employment Support (PES). This paper describes data from a focus group held with PES clients, conducted to evaluate the client responses to PES and to direct future service provision. While the focus group provided the expected data about client responses to PES, it also provided rich data about the impact of the shifting HIV/AIDS context on notions of sexuality and identity. This paper explores these ideas and the resulting implications for occupational therapists, especially those working within the field of HIV/AIDS.

Patterns of referral and intervention for persons with AIDS

OBJECTIVE

This study identified reasons practitioners receive occupational therapy (OT) referrals for persons with AIDS (PWAs). Frequency of OT interventions and perceived priorities of PWAs at each Centers for Disease Control and Prevention (CDC) stage of the disease's progression were examined.

METHOD

Surveys were sent to practitioners (N = 47) listed with AOTA having current or past work experience with PWAs. Twenty of the returned questionnaires were usable for analysis. Frequencies, ANOVAs, and weighted rank order statistics were used to bring meaning to the data.

RESULTS

Significantly more referrals for OT services were received for PWAs in Stages 3 and 4 of the disease than Stages 1 and 2 (F = 43.99, df = 3, p <.001). Referrals for early stages of the disease focused on role status, and play/leisure activities. In the latter stages, referrals for cognitive/perceptual skills, adaptive equipment, and caregiver training were more frequent. Frequency of interventions used by practitioners tended to mirror referral patterns, as did the perceived priorities of the PWA.

CONCLUSION

Reasons for referral and the interventions used with PWAs throughout the stages of the AIDS/HIV disease were similar to the perceived priorities of PWAs receiving services from OT practitioners, and reflected the typical symptoms experienced by PWAs at each CDC stage.