Abstract
Increasingly, mental health professionals, including psychologists, counsellors and social workers, are called upon to assist persons living with HIV to negotiate the mental health consequences of their condition. It has been suggested that serious mental health consequences following diagnosis with HIV are likely to occur and that developing countries may be “heading towards a mental health and social disaster” (Freeman, 2004). Freeman (2004) has identified various categories of persons affected by HIV who may experience psychological difficulties, including those recently diagnosed with HIV. Among recently diagnosed persons, it is thought that several psychiatric conditions may ensue, namely major depressive disorder (Gore-Felton, Koopman, Spiegel, Vosvick, Brondino & Winningham, 2006), generalised anxiety disorder (Pence, Miller, Whetten, Eron & GaGaynes, 2006) and posttraumatic stress disorder (Myers & Durvasula, 1999; Martinez, Israelski, Walker & Koopman, 2002; Olley, Zeier, Seedat & Stein, 2005). This article examines some theoretical concerns regarding the viability of a diagnosis of PTSD for persons who have received a diagnosis of HIV in terms of its implications for mental health counselling.
Highlights
Mental health professionals, including psychologists, counsellors and social workers, are called upon to assist persons living with HIV to negotiate the mental health consequences of their condition
Symptoms of avoidance, which is a cluster of PTSD, have been shown to predict lower CD4 counts, which is a measure of disease progression (Lutgendorf, Antoni, Ironson, Klimas, Fletcher & Schneiderman, 1997)
In a study of South African patients recently diagnosed with HIV and AIDS, Olley and colleagues found that 14,8% of their sample met the criteria for PTSD, of which 36% stated that the index trauma was knowledge of the diagnosis of HIV (Olley et al, 2005)
Summary
Mental health professionals, including psychologists, counsellors and social workers, are called upon to assist persons living with HIV to negotiate the mental health consequences of their condition. Freeman (2004) has identified various categories of persons affected by HIV who may experience psychological difficulties, including those recently diagnosed with HIV. A diagnosis with HIV is psychologically distressing, and newly diagnosed HIV-positive persons are likely to experience a range of social and emotional difficulties that stem from the knowledge that they have a life-threatening and contagious disease that will result in physical decline and death. 6% of newly infected South African patients attending immunology clinics had PTSD as determined by the Mini International Neuropsychiatric Interview (MINI) (Els, Boshoff, Scott, Strydom, Joubert & Van der Ryst, 1999); 50% among African American HIV-positive female sample had PTSD as assessed by the Composite International Diagnostic Inventory (CIDI) (Myers & Durvasula, 1999); and 16% among an American HIV-positive clinic sample had PTSD as measured by a PTSD Checklist (Leserman, Whetten, Lowe, Stangle, Swartz & Hielman, 2005). Symptoms of avoidance, which is a cluster of PTSD, have been shown to predict lower CD4 counts, which is a measure of disease progression (Lutgendorf, Antoni, Ironson, Klimas, Fletcher & Schneiderman, 1997)
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