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Query: UMLS:C0001175 (AIDS)
 120,706 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

To the longstanding cycle of poverty, disease, and despair that has afflicted several generations of Harlem residents have now been added epidemics of crack abuse, AIDS, syphilis, and pervasive violence. The community's children have been especially vulnerable to these calamities. Harlem's traditional institutions of strength, aid, and comfort--its extended families, churches, the hospital, and the government--have become nearly overwhelmed by mounting social disorganization and an apparent lack of resources. It may be possible to combat such problems by re-examining some of the assumptions we have used to deal with them, by energetically addressing their more manageable components, and by greatly increasing support for viable community institutions such as the public hospital. At the same time, we will need to learn many more facts about crack, AIDS, poverty, and shattered families so that, whenever possible, our efforts will be informed and our choices intelligent.
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PMID:Infant morbidity in Harlem: a status report. 168 16

In January 1988, an inmate-staffed hospice volunteer program began operation at a federal correctional medical facility, with the goal of meeting the unique psychosocial, palliative, and spiritual needs of terminally ill prisoners, primarily men with AIDS and cancer. This paper discusses sociocultural and psychosocial characteristics of the incarcerated patients and the prison hospital setting. It presents a number of case examples. Particular attention is given to the effect that an environment of intensified anger, hostility, distrust, and despair has on the coping mechanisms of terminally ill, incarcerated patients.
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PMID:Dying in prison: sociocultural and psychosocial dynamics. 193 34

AIDS has become far more than just another disease; it has become a sensitive political issue, a social and moral problem, a cause of international tensions, a favourite media story and a cause for despair among those who may be infected. Familiarity breeds, if not contempt, then at least complacency; the risk of infection for individuals, even those who are highly sexually active, is often not personalized - people still perceive AIDS as something that happens to other people, not to themselves.
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PMID:AIDS: can we cope? 262 Oct 81

The recent AIDS-related death of a friend forced Dr. Iain Mackie to think about the disease and the lack of positive news about it. Despite a flood of recent studies that brought pessimistic news about the treatments now in use, Mackie tries to remain optimistic. "I may be treating only myself as I feed off the politics of optimism," he says, "but at least I will not be feeding off the politics of despair." The article appears as Canada marks another National AIDS Week Oct. 2-8.
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PMID:The politics of despair: AIDS and the failure of treatment. 854 98

Whether they "come out" or hide their sexual orientation, most gay and lesbian youth experience the effects of prejudice and stigmatization emanating from society's homophobia. Having to cope with a disparaging and oppressive society creates unique stresses and developmental variations in identity development that are cofactors for HIV infection and disease. These cofactors include cognitive, emotional, and social isolation; feelings of alienation and despair; suicidal ideation; alcohol and other substance abuse; and furtive sexual contacts. Nurses and other providers need to be informed about these cofactors so they may provide meaningful HIV/AIDS prevention education to gay and lesbian youth.
J Assoc Nurses AIDS Care
PMID:Homophobia: a cofactor of HIV disease in gay and lesbian youth. 816 10

Survivors of multiple AIDS-related losses face threat to their identity because of the extreme disruption to their personal, assumptive, and interpersonal worlds. This article briefly explains the experience of multiple-loss survivors and includes a case history of a survivor. An individual's sense of self is transformed through identification with the disease. In the gay community, a particularly strong identification with AIDS arose. One outcome of the meshing of an AIDS and homosexual identity is the tendency for gays to assume an identity in relation to HIV ("I am HIV positive/negative.") Personality alteration is not uncommon and may include an inability to trust, labile emotionality, and diffuse anger. Erik Erikson's developmental stage model is used to clarify the confusion survivors face in maintaining and forming identity. Many survivors are catapulted into an integrity versus despair task, reporting many similarities with the situation of their grandparents. The survivor's interpersonal connection to the world, especially their connection to a community, is severely shaken. The article does not ignore the potential for positive identity growth arising from this tragedy. Conclusions from this experience may have applicability in other areas of multiple, ongoing losses.
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PMID:Threats to identity in survivors of multiple AIDS-related losses. 932 6

I was deeply moved by David Sanford's Wall Street Journal article, which follows. As David's story recounts, he came to me in deep despair. He believed that there was little hope to escape what is commonly termed a "death sentence" from AIDS. With state-of-the-art treatment, he has regained considerable health, as his HIV viral load has fallen to undetectable levels and his helper T-cell number has increased. How long these changes will be sustained and what the future holds are still unclear. But it is clear that David is pursuing life with great vigor and his sense of optimism and commitment to survive have been restored. I believe the hematologist/oncologist is in a particularly unique position in the clinical care of people with AIDS. Our history of conquering diseases which were, like AIDS, regularly associated with decline and death, gives us a perspective that engenders hope. I recall a friend and classmate in the fifth grade in Public School 187 in Queens, New York, who died of childhood leukemia. In those days, mentioning the word "leukemia" was forbidden, so our teacher informed us that Eric had died of "blood poisoning." We children all sat confused, wondering how to protect ourselves from such insidious "poisons." Childhood leukemia is now curable in the majority of afflicted children; I suspect that Eric would have been saved had the current treatment regimens existed in the early 1950s. Similar triumphs against lymphoma and testicular cancer are held up as real examples of progress in the field of oncology. I point to such victories in counseling patients with AIDS facing currently incurable diseases. AIDS is a moving target. Important breakthroughs in rational drug design provided us with the protease inhibitors, and laid the foundation for combination therapy which might potentially control the replication of the virus for decades and thereby restore longevity. Prospects for a true cure (full eradication of the virus from the system) are still hotly debated, but no one can deny that the clinical gains made in the last two years have been significant. We have witnessed the first clinical remission of AIDS. David Sanford's individual story is a mirror to the larger world of people with HIV. His restoration of health is not unique, not an isolated antidote, but a prototype of what is being seen in controlled clinical trials. Moreover, the importance of access to medical care, particularly new drugs, is evident from his tale. The impact of these new therapies on a humanitarian plane is the greatest, but its economic impact, with reduction of hospitalization, and increase in individual productivity, is also apparent. I find myself, as a physician, being importantly instructed by people like David Sanford. Our greatest gratification comes from science changing clinical reality, and restoring productive lives that become filled with realistic hopes.
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PMID:AIDS: A Personal Perspective That Engenders Hope. 1038 38

Life threatening illness, such as HIV/AIDS, also threaten people's sense of identity and taken-for-granted assumptions about the temporal framing of their lives. In response, people often experience transformations in values, spirituality and life priorities. Drawing on a combined quantitative and qualitative study of people living with HIV/AIDS in Australia, three different narratives that people use to make sense of their illness experience are identified: linear restitution narratives, linear chaotic narratives and polyphonic narratives. Linear illness narratives colonise the future, assuming that the future can be controlled through human action. They emphasise a faith in medical science, tend to be secular and self-centred and assume the end of life to be in the distant future. Hope is focused on concrete outcomes such as improved health or material possessions. Linear narratives can be either restitutive or chaotic. Restitutive linear narratives anticipate a life that will mirror the narrative. Chaotic linear narratives anticipate a life that will fail to meet the linear ideal resulting in despair and depression. In contrast, polyphonic illness narratives are oriented toward the present, emphasising the unpredictability of the future. These narratives tend to include spiritual experiences, a communally oriented value system, and to recount increased self-understanding and the gaining of new insights as a consequence of their illness. Hope in polyphonic narratives is more abstract and focused on a celebration of mystery, surprise and creativity.
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PMID:Illness narratives: time, hope and HIV. 1065 42

The knowledge that her child is infected puts a heavy emotional burden on a mother. Despair or depression lead to difficulties in reacting to the options and advice given by health workers. The compliance of the mother also is largely dependent on her acceptance of the HIV status of the child. Additionally, the belief that the child might die any moment may cause her not to take proper care of the child anymore. Worries of the caretakers are frequently related to poverty. Counselling of caretakers at the health centre could and should be an important element in care for HIV-infected children. Psychological and material support and advice concerning HIV infection, proper childcare and material problems may empower the caretakers. This may lead to a better follow-up of the child by health care workers and to increased compliance of and better care by the caretaker, which will improve life and survival of an infected child.
AIDS Care 2000 Oct
PMID:Psychosocial and economic aspects of HIV/AIDS and counselling of caretakers of HIV-infected children in Uganda. 1121 40

The purpose of this study was to describe voluntary caregivers' observations on the dynamics of hope across the continuum of HIV/AIDS. Three focus group interview sessions were conducted with 10 voluntary caregivers in 1998. The data were analyzed using the grounded theory method described originally by Glaser and Strauss. Closing and opening emerged as the core categories in the dynamics of hope. Closing means closing down in despair and to the process of life, whereas opening means opening up to hope and the process of life. Nursing interventions that prevent closing and enable opening are helpful for these people. Conceptual clarification and the differentiation between the concepts of hope, wish, despair, and hopelessness presented in this study require further elaboration. Further research on the dynamics of hope in fearing HIV/AIDS or living with HIV/AIDS and being a significant other to a person with HIV/AIDS from different perspectives is also needed.
J Assoc Nurses AIDS Care
PMID:Voluntary caregivers' observations on the dynamics of hope across the continuum of HIV/AIDS: a focus group study. 1129 33


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