Dépendance affective et autonomie relationnelle chez l’adolescent infecté par le VIH

Abstract

BackgroundDisclosing the diagnosis of human immunodeficiency virus (HIV) to an adolescent is a controversial and emotionally charged issues amongst both the health care teams and parents and adolescents. Disclosure may be seen as an ongoing process as the adolescent develops cognitive, psychological and spiritual awareness about the meaning of illness for HIV-infected adolescents. Most of the work undertaken highlights five dimensions: diagnostic information, typical identity crisis of the adolescence and its serious repercussions on the compliance, relationships within the family and interpersonal problems (discrimination, exclusion, the burden of silence), teenage body's subjectivation and sexual opportunity, advent of traumatic transgenerational events. MethodsAdolescence is a time of intense social pressure to “fit in” and be “normal”. The diagnosis of HIV has a value of traumatism and changes the conditions of adolescent autonomy. From two clinical observations, we offer to question the somatic vulnerability induced by HIV-infection and understand the cross impact between disease and adolescence process. ResultsThis presentation makes it possible to highlight two data series: specific issues of damage of personal freedom, independent relationships for adolescent; emotional support and psychological care. This article explores the interactions between medical reality and psycho emotional development of the adolescent, the cohesion of an enabling environment and a relational support system for the patient. If healthcare professionals who take care these adolescents are highly sensitized to and mobilized about the particularities of these registers, we hereby show that comprehensive support for individuation and autonomy should also draw upon the difference, feelings of inadequacy and injustice, the fear of social dishonour, as well as, the recognition of disability associated with HIV/AIDS. Complex psychological issues in caring for adolescent living with HIV revolve around narcissistic problem and mobilizes a real psychic work. Its can enable to restore the harmony with myself and the community, establish sufficient autonomy for self-esteem and sense of safety. ConclusionThis will thus lead us to evidence the importance of the construction of identity, emotional maturity, security of warm relationships and the dynamics of psychotherapeutic consultations. Finally, we need to move our understanding of support for both adolescent and parents from an individualized, dynamic and gradual process of communicating information about illness, health and living.