Career Counseling With Persons Living With HIV: An Ecological Approach

Abstract

Advances in medical treatment have greatly extended the life span and quality of life of persons living with HIV, with the nature of the disease evolving from causing an early death to chronic, manageable illness. Career counselors will increasingly be called upon to assist persons living with HIV. This article provides an overview of HIV disease and of career-related issues unique to persons living with HIV. Career counseling interventions are discussed from an ecological perspective. Career counselors are called on to assist diverse populations in the process of career development, and recent approaches to career counseling have emphasized the importance of providing appropriate services to such populations. Although the needs of persons living with HIV have been examined in the general counseling literature, only one study (Hunt, Jaques, Niles, & Wierzalis, 2003) has addressed the career counseling concerns of persons living with HIV. The purpose of this article is to highlight the unique concerns faced by this population and to provide career counselors a model for conceptualizing and designing career counseling interventions in working with individuals with HIV. We use an ecological perspective (Cook, Heppner, & O'Brien, 2002) to build an understanding of career-related needs of individuals with HIV and to create an organized, intentional approach to addressing such needs. Specifically, this article includes (a) current trends in HIV/AIDS disease, (b) the role of work for persons with HIV, (c) career counseling implications, and (d) a case illustration. HTV Today Approximately 900,000 persons in the United States are living with HIV; an additional 40,000 persons become infected with the virus annually (Centers for Disease Control and Prevention [CDC], 2000). HIV is a virus that leads to the destruction of blood cells that normally protect the body from infection; the disease may cause a variety of health problems that lead to a diagnosis of AIDS (CDC, 200Ib). Of the 900,000 persons living with HIV in 2001 in the United States, 362,827 individuals were known to be living with AIDS (CDC, 2001a). Because of the seventy of symptoms most often associated with AIDS, this discussion focuses on career counseling approaches for persons with an HIV diagnosis. Persons living with HIV represent a diverse proportion of the American population, but new HIV infections have occurred disproportionately according to gender (70% men) and race (54% Black; CDC, 2000). African Americans are 10 times more likely than Whites to contract HIV, with incidence rates increasing most rapidly among African American women and other women of color (CDC, 1999). The CDC identifies the most common risk factors for infection as men having sex with men (42%), heterosexual contact (33%), and injection drug use (25%). HIV most commonly affects young adults, with more than one half of new infections occurring in persons under 25 years of age (CDC, 2000). Career theorists have identified early adulthood as a key period in career development that influences how an individual functions in other life roles (e.g., Super, 1990). Although HIV most often affects those in the early stages (under 25 years of age) of career development (Fesko, 2001; Hoffman, 1996, 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 HIV/AIDS (Brooks & Klosinski, 1999; McReynolds, 2001; SaIz, 2001; Yallop, 2000). Although such services remain necessary, the shift in HIV/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. The course of HIV/AIDS has been drastically changing since the introduction of a class of medications known as protease inhibitors in the mid-1990s. …