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

Abstract

Patton (1985) described sexuality as being made up of sexual identity, sexual practice and sexual desire, but recognised that there was not necessarily a connection 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.

Understanding the Experience of HIV/AIDS for Women: Implications for Occupational Therapists

“…Due to medical advances in medications and interventions for HIV and AIDS, there has been an improvement in health and life expectancy (Fish & Rudman, 1998;O'Dell, Crawford, Bohi, & Bonner, 1991;Yallop, 2000). This has resulted in a shift from being an acute, terminal disease to one that is more chronic and episodic in nature.…”

Career Counseling With Persons Living With HIV: An Ecological Approach

“…Although HIV most often affects those in the early stages (under 25 years of age) of career development (Fesko, 2001;Hoffman, 1996Hoffman, , 1997, there is a dearth of literature regarding career counseling with persons living with HIV, This lack of information may be due to the reality that earlier an HIV diagnosis meant rapid, progressive disability. For this reason, services for persons living with HIV focused on providing case management services to individuals who were dying from HIVIAIDS (Brooks & Klosinski, 1999;McReynolds, 2001;Salz, 2001;Yallop, 2000). Although such services remain necessary, the shift in HIVI AIDS from fatal disease to long-term, chronic illness has created a need for attention to the process of living with, rather than dying from, the disease.…”

“…Although the management of medications to treat HIV and symptoms previously served as a full-time occupation for many individuals living with HIV (Yallop, 2000), protease inhibitors have allowed a considerable number of them to continue working or to return to the workplace after a period of disability (Bettinger, 1999). Known as the "Lazarus Syndrome," declining mortality rates and improving health have led to a rapid increase in the number of persons living with HIV who are feeling well and considering reentering the workforce (Gant, 2000;Goodman, 1997;Richardson, 1997).…”

“…Specific benefitsinclude feeling better about oneself (Brooks & Klosinski, 1999;Fesko, 2001;Salz, 2001); sense of independence (Salz, 2001); and fulfillment of personal needs such as well-being, dignity, meaning, and sense ofaccomplishment (Bettinger, 1999;Brooks & Klosinski, 1999;Hoffman, 1996;Timmons & Iesko, 1997). Work is also associated with providing an individual with a positive sense of identity as a contributing member of society (Hoffman, 1996;McReynolds, 2001;Salz, 2001;Timmons & Iesko, 1997) rather than as patient (Barroso, 1999) or victim (Yallop, 2000).…”

“…Often they have spent a considerable amount of time in the role of patient (Yallop, 2000). Although this role is likely to have changed in recent years, the individual's ability to maintain complex medication regimens (Yallop, 1999) and to regularly attend medical appointments will still be The Career Development Quarterly vital.…”