Bridging the Gap: Conference Record [Abstract book, International Conference on AIDS (12th: 1998: Geneva, Switzerland)]

12th World AIDS Conference

Abstracts 24238-24243 487

24238 Music therapy: A creative mental health service for
people with HIV/AIDS
Romeo Desmarais, D.A. Brodie. DMC-Canfield health services 50 E. Canfield,
Detroit, Michigan 48201, USA
Issue: Music therapy is a safe, exciting, and creative way for people with HIV/AIDS
(PHAs) to discover, explore, and work through personal issues related to their
condition. Empirical research indicates that music therapy plays a role in improving immune system functioning. The non-verbal component of music therapy
compliments traditional psychotherapy, especially for clients who have difficulty
verbally expressing and articulating their thoughts and feelings.
Project: Individual and group music therapy sessions have been conducted
at Canfield Health Services (CHS), a federally funded agency that provides free
professional mental health services to PHAs in Detroit, Michigan, USA. Music
therapy activities include song lyric analysis, relaxation training, guided imagery,
and improvisation. Individual treatment goals are created in collaboration with an
interdisciplinary treatment team. In addition to providing a focused creative outlet,
music therapy addresses issues such as self-exploration, stress management,
and social support.
Results: Since its introduction in January 1997, 29 clients have received individual and/or group music therapy services. To date, clients have attended
between 2 and 17 sessions. Participation is most often concurrent with other CHS
services, although some clients attend music therapy exclusively. Preliminary
analyses reveal that overall, clients evaluate the program very favourably, with a
mean rating of 6.04 on a 7-point, Likert scale. The clients' own words are also
testament to the program's success: "Music is key to therapy," "It help[ed] me to
relax and it took me to a peaceful place," "The thing I enjoy the most is finding
out what my visualization says about my true feelings."
Lessons Learned: Thus far, music therapy has emerged as a dynamic and
invaluable addition to the mental health services provided by CHS. Because
music therapy is still a relatively new and unknown mental health profession,
an extensive outreach project has been implemented to inform AIDS service
providers and users about music therapy and its various applications. It is hoped
that such efforts will increase the number of people who may participate in and
benefit from this unique program.
24239 Acute stress disorder assessment and intervention in
newly diagnosed HIV+ women
Sharon Rae Jenkins. Phychology Dept. PO Box 311280, University of North
Texas, Denton, TX, USA
Background: HIV+ diagnosis is often unexpected and traumatic for women in
the Midwestern US due to high levels of traumatic life events: poverty, histories of violence and abuse, and drug-involved lifestyles. Research shows that
HIV+ women tend to self-isolate and avoid treatment after HIV+ diagnosis until
symptomatic. Post-diagnosis Acute Stress Disorder (ASD) symptoms may impede HIV+ women's health care. Intrusive thoughts may complicate adherence to
complex medical regimens; avoidance may distance women from care altogether
and from supportive social networks; hyperarousal is a physiological stressor.
Methods: This NIMH-funded study interviewed 23 newly diagnosed (~2 weeks)
HIV+ women (18 African-American, 5 white, mean age 31, 6 with known HIV+
male steady partners, 19 with children - all HIV-) at two inner-city Health Department confidential HIV test sites to pilot-test a single-session individual mental
health intervention to identify stressors, reduce acute distress, assist in coping,
and help them plan for adaptation to diagnosis, including serostatus disclosure,
longer-term coping, and maintaining HIV supports and health care.
Results: Reported HIV risks were 22% own injection drug use; 48% sex with
known HIV+ man; 22% many male partners. 52% reported a sexual assault
history, including childhood. ASD symptom levels resembled disaster victims (Revised Impact of Event Scale means: Intrusion 17.4, Avoidance 20.7, Hyperarousal
18.2, Total [IESTOT] 56.3). Correlations with IESTOT: sexual assault 0.56, current
health rating -.65. Nearly all said that "having someone to talk to who would
listen" was the most important part of the intervention.
Conclusions: These women's ASD symptom levels were high enough to interfere with adaptation to diagnosis and pursuit of care. Diagnosis and treatment
of ASD symptoms may assist patients' participation in medical regimens. Patient education may improve attention and concentration, encourage cooperation,
and forestall withdrawal, especially for women. HIV professionals should know
that ASD symptoms may interfere with patients' full processing of health care
information.
S24240 The effect of disclosure of HIV+ diagnosis and other
social circumstances on the psychological changes in
minds of the diagnosed people
Dmytro Guskov. UI. Entuziastov, Kiev, Ukraine
Issue: The disclosure of HIV+ diagnosis coupled with some other social factors
might have severe consequences for mental health of the diagnosed people,

and the complex effect of disclosure is one of the priority targets for AIDS
psychotherapeutic work with this category of clients.
Project: The disclosure of HIV+ diagnosis might have different forms and
be made either voluntary or without consent/against will to different people by
different professional bodies. In any case the life of people whose HIV+ diagnosis
was disclosed gets distinctive features. One of them is a comparatively rapid and
severe progress of mental health problems in HIV+ diagnosed people.

The project combines the measurement of psychological changes in the minds
of HIV+ diagnosed people with the collection of exhaustive information about
their social circumstances in Ukraine. The long-term monitoring of the changes
in minds of the HIV+ diagnosed people allow to reveal by means of correlation
analysis the impact of the disclosure on both other social circumstances and the
progress of mental problems per se.
Results: The disclosure of HIV+ diagnosis is rather typical in Ukraine. It affects
very many other social circumstances of HIV+ diagnosed individuals, first of all
the relationships with family and friends, as well as job and accommodation. Both
the disclosure and the affected social circumstances in their turn affect the state
of mental health of HIV+s.
Lessons learned: While the process of the disclosure of HIV+ diagnosis without consent and/or against will should be combated by the relevant legislation
and medical profession, the psychological effect of the disclosure which can lead
to the serious mental health problems is the target for psychotherapeutic work
and/or long term counselling.
24241 1 Psychotic patients and HIV/developing a psychiatric
mobil team: Experiences in the south of France
(Marseille)
Saadia Mokhtari1, M.C. Castano2, M.C.R. Rousseau3, C.C. Chauchon2,
J.M. Moreau3. 120 Rue de la Grande Armee 13001 Marseille; 2Hospital Edouard
Toulouse 13013 Marseille; 3Hospital Houphouet Boigny 13015 Marseille, France
Objectives: To value the evolution of 26 psychotic patients with confirmed HIV
infection, and described the role of the psychiatric mobil team.
Design: retrospective described study.
Methods: 26 files of patients were followed during 2 years (1996/1997).14
Schizophrenia 4 paranoid states, 4 manic depressive psychoses; 2 cyclothymic
personality, 2 psychotic personality. 23 adults males and 3 adults females;aged
between 30 and 55 pears.
Results: the regularity of the following has been noted;the patients come every months if they have schizophrenia, 3/4 of the others patients come every
months also. Injections drugs are the principal mode of transmission, most of
our patients were considered intravenous drug users before the psychos was
diagnosed. Once the psychoses has been diagnosed, the patients are taken in
care by the psychiatric unit, which contributes in a large parties to the treatment
of HIV infection.
Conclusion: the psychiatric mobil team assured the liason between psychiatric hospital, medico-psychologic center and somatic care (outpatients unit), the
hospital Houphouet BOIGNY for infectious diseases is situated in the northern
parties of Marseille, a high number of income buildings with grave problems
socio-economic are noted in this area.
24242 | HIV positive women and their social representation of
motherhood
Cristiane Cabral. Rua Granja N. 51 Bloco 4 Apt. 402, PENHA, Rio De Janeiro,
Brazil
Issue: HIV infected women of childbearing age and the different meanings of
motherhood for their lives.
Project: Taking into consideration that motherhood is a very important fact in
our culture and that a rapid increase in the number of HIV infected women of
childbearing age has been taking place, this study was developed in other to
analyze the meanings, the perceptions, the place of motherhood in these women
lives. It's a qualitative research in which semi-structured interviews were done
randomly. The Social Representation theory was used to analyze the results.
Results: Nine women, patients from a public hospital in Rio de Janeiro, were
interviewed and their ages varied from 19 to 36 years old. Two of them were
single, three were widow and four were married. Out of nine, four women were
mothers already. These women who had already given birth showed more vitality
which, in their opinion, was a consequence of their status since their children
represented their reason to fight for their lives. Coincidentally or not, out of these
four, only one took an anti-retroviral medicine (AZT). The five women who weren't
mothers felt deeply the effect of this great gap in their lives, being another very
difficult thing to face and carry on. Although all of them expressed a wish of having
a baby, as it would be a wonderful thing to happen, they said they couldn't or
mustn't have one since they might infect their babies that way.
Lessons Learned: The possibility of being mother can play an essencial role
in women's identities, and even define the meaning of their lives. This strong
desire should be taken into consideration when we deal with HIV positive women
as long as it can represent a great psychological suffering which may show its
effects in their health.
545*/24243 Grief at work: Helping organizations cope with
AIDS-related loss
Stuart Gibson1, A. Plotnick2, D. Scott3. DMC-Canfield health services 50 E.

Canfield, Detroit, Michigan, USA; Ernst & Young Toronto ON Canada, AIDS
Bereavement project of Ontario, Toronto, ON, Canada
Background: The purpose of this project was twofold: (1) to assess the impact of
AIDS-related multiple loss on AIDS-service organizations (ASO) in the province of
Ontario, Canada; and (2) to evaluate the impact of the AIDS Bereavement Project
of Ontario (ABPO), an agency that assists organizations in coping effectively with