EATN: European AIDS Treatment News

therapy for someone with HIV, the
necessity for patient compliance,
drug interactions, side-effects, a
description of the patient burden
when using a specific combination
was given by a member of the
committee on medical information of
the HIV association. A personal
experience was given by someone
already using a combination. A
computer network (HIVNet), a
magazine (HIV News) and periodicals
(AIDS, the state of affairs) provided
more information.
Caring and carees
Carlisle, University of Liverpool,
England
Emotional experience and caring
for HIV positive people. 41 interviews
were done with 21 carers. Aspects of
the emotional experiences were
faceing the diagnosis, living on the
fringe and coming out. They felt no
right to ask for support. They tried to
hide their own needs. Problem areas
were the disclosure of information to
others about the loved one's HIV
status, the feeling of being rejected,
a growing isolation, stigmatizing the
careers.
Gray &Hedge- psychological wellbeing and coping in the partners of
gay men with HIV related disease
Questionnaire was used with 35
HIV negative partners. A high level of
psychological stress was found in the
partners of gay men with HIV, one of
every two scoring as psychiatric case.
(what does a "psychiatric case"
mean?) Coping mechanisms &
strategies in negative carers. Coping
strategies of acceptance, positive
interpretation, emotional support
and social support - behavioural
disengement were correlated with
psychological stress. Important
predictors of anxiety and depression
included behavioural disengagement
and overall health of the infected
partner. Other significant variables
for well-being included satisfaction
with social support and stressful life
events.
Pakenham et al: Application of

stress/coping model for burnout in
volunteers caring for persons with
HIV

Volunteer caregivers are
vulnerable to a high level of stress
which may result in burnout. A total
of 160 volunteers in Australia
completed questionaires at a specific
time and again two months later.
28% reported a high level of
burnout, 11% moderate to extremely
high levels of depression. The
majority (85%) were highly satisfied
with their volunteer work. Results
indicated that social support was
negatively related to depression, the
client's level of physical dependence
was negatively related to emotional
exhaustion. Results support
preventing and relieving burnout.
Changing Patterns
of risk among gay
and homosexually
active men
Grulich et al: National Centre in HIV
Epidemiology and Clinical Research
Sydney
Risk factors for HIV seroconversion
in homosexually active men: a
comparison of cohort (n=67) and
case-control (n=39) study. 81% of
the seroconverted men reported
unprotected receptive or insertive
anal intercourse. More men
seroconverted among those using
recreational drugs/amyl nitrate, but
there was no statistical significance.
At the event of seroconversion, many
were intoxicated, although they did
not show signs of long term abuse.
The risk to seroconvert seems to be
8-fold. There was no association or
statistical significance concerning the
risk in oral sex with ejaculation with
a casual partner. There were two
cases of seroconversion where oral
transmisson was likely the route of
infection, having no previous anal
intercourse. No oral/penile lesions
were present. Ejaculation was not
associated with risk.
In discordant couples the risk is
35-fold, 42% seroconverted with a
regular partner (half of these in a
relationship of less than 3 months)
and 58% with a casual partner.

Reasons for unsafe sex were "done
before, love" with a casual partner.

Social support
Lubeck et al -Stanford University
451 HIV positive men were
followed for a minimum of 2 years
following the self-reporting of
current health, pain, presence of
disease symptoms and physicianreported CD4 counts. Changes were
evaluted by disease stages of
asymptomatic, symptomatic and
AIDS. Differences were statistically
significant for general health. Higher
baseline social funtioning was
significantly correlated with
improved general health, reduced
pain and fewer symptoms after 2
years.
Alexius & Blomqvist- Karolinska
Institute, Stockholm Sweden
23 HIV+ women from a psychiatric
out-patient unit for HIV-infected
patients were compared with 33
HIV+ men. Coping capacity was
assessed by comparing the total
number of recorded activities with
other people in the past with
assumed activities in the future. Past,
present and future possibility to
control activities were lower for the
women. The scores of the women for
sadness, pessimism and fatigue were
elevated. 12/23 women met the
criteria for psychiatric disorders.
Calzavara - Ontario HIV
Seroconverter Study team
18 subjects of an HIVseroconverter cohort study were
asked how their lives have changed
since they learned they were HIV+
about 8 months earlier. Reactions to
being told that they were HIV+ were
disbelief, fatalistic acceptance and
it's over. One of every two was still
having difficulty adjusting. They
were "depressed",. "constantly
worried", "still very devasted",
"angry". The other 9 were "hopeful",
"taking charge", "become part of my
life" and "more at ease with it".
Adjustment/ acceptance of HIV+ life
was associated with gender, time
since HIV+, sexual orientation, mode
of infection and social support, but
not with age or ethno-racial group.
Women (5/6) were having more
difficulties adjusting regardless of

their mode of infection or time since
diagnosis. Disclosure was also

14 WINTER 1997/98