Wednesday, February 6, 2013

The Role of Health Psychologists with HIV/AIDS Patients

Psychosocial interventions, similar to those used for cancer patients may be used for HIV/AIDS as well. At this time, there is a paucity of research on the overall improvement of life quality gained from group support, complementary therapies, relaxation techniques, and various coping skills. Additionally, research is needed on the adoption of religion and spirituality by HIV/AIDS patients (Cotton et al., 2006). Religious and spiritual patients demonstrate better overall mental health and decreased HIV/AIDS symptoms (Pargament et al., 2004; Yi et al., 2006). Future research could identify the effects of providing a spiritual support network shortly after diagnosis (Cotton et al., 2006).

Bing et al., (2001) found over 40% of HIV/AIDS patients use illicit drugs, and more than 12% of these individuals were drug dependent. Further, many of these patients had psychiatric disorders (Bing et al., 2001). Drug and alcohol abuse and psychiatric disorders interfere with treatment adherence (Gonzalez, Batchelder, Psaros, & Safren, 2011; Kim et al., 2007), they cause patients to become an excessive burden to caregivers (Bing et al., 2001), and they influence health outcomes (Bing et al., 2000). Furthermore, abuse and mental disorders may require additional health care, and cause patients to engage in more negative health behaviors (Bing et al., 2001). Research into more realistic and effective means of treating these issues in HIV/AIDS patients may help control the additional health care costs associated with drug abuse and dependence as well as increase the quality of life for these patients (Sherbourne, et al., 2000).

Although there is a surfeit of information on alcohol and drug abuse in HIV/AIDS patients, there is little research on co-occurring mental and substance abuse disorders, their distinct and specific implications, and the drug-specific effects of illicit substances abused by these patients. Further, research is needed on how to encourage these patients to engage in helping services (Klinkenberg & Sacks, 2004). Because many of these patients receive psychological and psychopharmacological help from primary care doctors rather than psychological professionals, it may be important to determine the effectiveness of this counsel and the medications these doctors prescribe (Klinkenberg & Sacks, 2004). Additionally, further research is necessary on the impact of co-occurring psychological and substance disorders for minority populations as well. For example, African American HIV/AIDS patients access far less care for psychological health (Klinkenberg & Sacks, 2004). Closing the gaps in care for minority patients is critical, but first, research must determine why these gaps exist and how best psychologists can fill them.

Although the stigma associated with HIV/AIDS is well known, additional research is needed on how to effectively reverse negative perceptions, and more especially, how to effect this change in various populations. In cultures wherein religious and other contexts compound negative perceptions, the study of tailored, effective awareness campaigns is warranted. Because HIV/AIDS is treated as a chronic disease and long-term survival has become a realistic goal, quality of life for these patients has become more important (Sherbourne et al., 2000). Creating effective solutions for the complex issues associated with HIV/AIDS can help to normalize life after diagnosis for these patients.


Bing, E. G., Burnam, M., Longshore, D., Fleishman, J. A., Sherbourne, D., London, A. S...Shapiro, M. (2001). Psychiatric Disorders and Drug Use Among Human Immunodeficiency Virus–Infected Adults in the United States. Archives of General Psychiatry, 58(8). 721-728. doi:10.1001/archpsyc.58.8.721.

Bing, E. G., Hays, R. D., Jacobson, L. P., Chen, B., Gange, S. J.,Kass, J. S. & ... Zucconi, S. L. (2000). Health-related quality of life among people with HIV disease: results from the Multicenter AIDS Cohort Study. Quality of Life Research, 9(1). 55- 63.

Cotton, S., Puchalski, C., Sherman, S., Mrus, J., Peterman, A., Feinberg, J., & ... Tsevat, J. (2007). Spirituality and religion in patients with HIV/AIDS spirituality and religion in patients with HIV/AIDS. Journal Of General Internal Medicine, 21S5-S13.

Gonzalez, J. S., Batchelder, A. W., Psaros, C., & Safren, S. A. (2011). Depression and HIV/AIDS Treatment Nonadherence: A Review and Meta-analysis. JAIDS Journal of Acquired Immune Deficiency Syndromes, 1. doi: 10.1097/QAI.0b013e31822d490a

Kim, T., Palepu, A., Cheng, D., Libman, H., Saitz, R., & Samet, J. (2007). Factors associated with discontinuation of antiretroviral therapy in HIV-infected patients with alcohol problems. Aids Care-Psychological And Socio-Medical Aspects Of Aids/Hiv, 19(8), 1039-1047.

Klinkenberg, W. D., & Sacks, S. S. (2004). Mental disorders and drug abuse in persons living with HIV/AIDS. AIDS Care, 16S22-S42. doi:10.1080/09540120412331315303

Pargament, K. I., Mccarthy, S., Shah, P., Ano, G., Tarakeshwar, N., Wachholtz, A., & ... Duggan, J. (2004). Religion and HIV: A Review of the Literature and Clinical Implications. Southern Medical Journal, 97(12), 1201-1209.

Sherbourne, C. D.. Hays, R. D., Fleishman, J. A.,Vitiello, B., Magruder, K. M., Bing, E. G. & ... Shapiro, M. F. (2000). Impact of psychiatric conditions on health-related quality of life in persons with HIV infection. American Journal of Psychiatry, 157248- 254.

Yi, M., Mrus, J., Wade, T., Ho, M., Hornung, R., Cotton, S., & ... Tsevat, J. (2006). Religion, spirituality, and depressive symptoms in patients with HIV/AIDS. Journal Of General Internal Medicine, 21 Suppl 5S21-S27.

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