Recent reports suggest that human immunodeficiency virus (HIV), the virus causing AIDS, may cause autonomic nervous system (ANS) dysfunction. ANS abnormalities on cardiovascular reflex tests have been demonstrated in HIV+ persons, persons infected with HIV, who have signs of illness or have used intravenous drugs. In this study the cardiovascular reflex function of 11 HIV+ homosexual or bisexual males meeting the Centers for Disease Control criteria for absence of illness was compared to that of 11 uninfected homosexual or bisexual males of similar ages. Somatic, depression and fatigue differences between groups were assessed using an ANS symptom checklist, the Beck Depression Inventory (BDI) and the Profile of Mood States (POMS). Six of the 11 HIV+ subjects were impaired on the cardiovascular reflex tests. Differences on the BDI and POMS were not attributable to a depressive mood or despair, but rather to presence of mild symptoms of HIV infection and fatigue.

Documentation of neurological complications and neuropathological findings arising in most AIDS patients has stimulated the need for an investigation of the brain-behaviour relationship associated with human immunodeficiency virus (HIV) infection. This study aimed to verify the hypothesis that a chronic subclinical AIDS dementia exists in view of the neurotropic quality of HIV. Participants were 59 male homosexuals distributed as follows: 17 healthy HIV seronegative, 14 healthy HIV seropositive, 14 AIDS-Related Complex, and 14 AIDS. They were administered a comprehensive battery of neuropsychological tests, including measures of attention, cognition, memory, language, executive, and sensorimotor functions. An examination of the emotional and psychological concomitants was performed using questionnaires of personality (MMPI), anxiety (STAI), and health-related behavioural dysfunction (SIP). Group comparisons were conducted on the basis of Health Status (Healthy vs Nonhealthy) and Medical Diagnosis (HIV-, HIV+, ARC, & AIDS). Results revealed a significant Health Status effect overall, as well as evidence for a deterioration of higher mental abilities occuring with progression of HIV infection. These findings appear to be independent of the emotional and psychological factors, which are felt to be an integrative part of the AIDS-Dementia Complex (ADC). / Graduate

Objectives. Explore and describe the impact of premature life-threatening illness, stigma, multiple loss of significant others, decreased vocational choice and mobility and decreased financial security among young gay men living with AIDS. It was hypothesized that young gay men with AIDS and the elderly experience similar physical, social, and psychological changes, but the cognitive adaptation to these changes are hindered by the non-normative timing of these events. / Methods. Thirty-two self-identified gay men with AIDS between the ages of 22 to 44 years were recruited from an out-patient clinic in Montreal. These participants were asked to complete a comprehensive questionnaire, which assessed the respondent's daily stress, impact of HIV, health-related quality of life, ways of coping, multiple loss, dependency on informal and formal supports, and preparation for death. Quantitative methods were used to analyse the data. / Results. The hypothesis was confirmed. Respondents reported relatively low levels of health-related quality of life, significant concern over health and financial security, considerable multiple loss, increased dependency on informal and formal supports, proportionally greater use of active coping strategies, and significant concern about discrimination. / Conclusions. A comprehensive method of intervention which addresses all of the biopsychosocial aspects to care is proposed. It is suggested that a coordinated multidisiciplinary approach to clinical and research endeavors should be adopted to address the multidimensional obstacles facing young gay men with AIDS.

The objective of the proposed research study was to answer the following research questions: Do clients in their respectful stages of diagnosis place more emphasis on certain psychological issues than others? And if so, can we identify the specific psychological issues that were considered to be most significant and unique across the stages of the HIV/AIDS continuum? To test these research questions, 37 homosexual men falling in three specific stages of the infection were surveyed. These three stages included: (1) HIV+ asymptomatic, (2) HIV+ chronic symptomatic, and (3) AIDS diagnosis. The HIV/AIDS Client Concern (HACC) questionnaire was developed to assess the significance clients placed on certain psychological issues and, was administered to all the subjects. The statistical analyses revealed that clients' level of diagnosis influenced how much emphasis they placed on what they considered to be significant psychological issues. More specifically, clients in the asymptotic group reported a higher concern with issues surrounding confidentiality of their HIV/AIDS status than the AIDS diagnosis group. The chronic symptomatic group, on the other hand, was significantly more concerned with issues regarding feelings of guilt/shame, shock, depression, fear, loneliness, and anxiety of infecting other people through casual contact than the other groups. In addition, the AIDS diagnosis group was most concerned with issues surrounding the planning of their future care in comparison with the asymptomatic group. A more detailed analysis of each questions' content and its significance as well as the implications such results have for both researchers and practitioners alike will be discussed.

No description available.

Includes bibliography. / The acquired immune deficiency syndrome (AIDS) is primarily a sexually transmitted disease. The majority of those infected in the First World are homosexual and bisexual men, and intravenous drug users. The study combined a literature review and a case example to explore psychosocial needs of homosexual AIDS patients with a view to presenting recommendations for mental health practitioners to help alleviate the psychosocial trauma of these patients and their significant others. The literature review focussed on the psychosocial experiences of homosexual AIDS patients; their losses, reactions of their significant others; their emotional reactions to medical treatment, and, psychosocial treatment issues and approaches. The case example was a twenty-nine- year old hospitalized homosexual male. Information was received from the patient's befriender, his lover and from the patient himself. The reactions and experiences of this patient were concomitant with many of those discussed in the literature review, namely: The patient suffered major losses: employment, income, house and household possessions as well as social status, with the primary psychosocial effect of loss of independence and control. The patient also experienced some isolation and rejection from some friends, family and hospital staff, and geographical isolation for a period of time from his lover and family. He displayed anger and denial - aspects of his personality which were evident prior to his diagnosis but exacerbated by his illness.

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No description available.

The purpose of this study was to generate a grounded theory explaining the social and psychological processes employed by gay men in living with the threat of Acquired Immunodeficiency Syndrome (AIDS). As members of the high risk group for AIDS, gay men are living with a prolonged threat of unprecedented complexity which has unknown demands on health. An exhaustive preliminary literature review revealed a dearth of theoretical or empirical data addressing this problem. Theory discovery was accomplished using the grounded theory methodology. Two major data collection procedures were utilized: The conduct of increasingly structured interviews of healthy gay men, and an ongoing, progressive literature and media search. Data were sampled theoretically, as guided by the emergent theory. The constant comparative method of analytic induction was used for the analysis of data, in order to identify the elements and structure of the theory. Multiple procedures were incorporated into the analysis to ensure its trackability and credibility. A basic social process, Surviving Survival, was identified as the core category of the theory. Surviving Survival is the continuous process used by gay men to ensure mortal survival as well as outlive the extremity of the AIDS threat. The process is comprised of three subcategories: Vigilance, Safeguarding, and Balancing. The subcategory of Vigilance explains the work of monitoring the threat of AIDS and has both personal and social components. Safeguarding explains the behavior of protecting self and others from the AIDS threat, including AIDS' eventuality. The subcategory of Safeguarding contains Safer Sex, Reassuring Others, and Forecasting. The subcategory of Balancing explains efforts to conserve energy required to sustain affirmation of life and living in spite of the AIDS threat. In continuous interaction, the subcategories of Surviving Survival are interwoven into multiple aspects of gay living. This theory explains the profound impact AIDS has on the mental health of gay men, who both survive and perceive the extremity of the AIDS threat on a daily basis. These findings provide a knowledge base for the nursing discipline in becoming an informed and informing resource for the men who are outliving the threat of AIDS.

This ethnography of intravenous (IV) drug users challenges popular representations of a "junkie" subculture and stereotypes of users as rejecting the dominant cultural values of mainstream society. Users attempts to construct and maintain a moral identity are examined. Beyond "war stories" ennobling street life and survival, life narratives were constructed through a juxtaposition of voices and images establishing moral worth in opposition to others. Moral identity is a central concern for IV drug users, one influencing their response to risk. Social relations, responsibility, and an ethic of care were found to underlay the moral codes developed by users, codes socially-embedded and to some degree gender specific. Men tended to adopt a "tough guy," "independence" voice in which responsibility was largely framed around status and image as a role model. Women tended to see responsibility and morality within a web of interdependence and care. Social responsibility was a measure of moral goodness. The desire to be defined by mainstream values was strongly evident among women users who were mothers. Motherhood was a core symbol representing inherent goodness, a marker of moral identity, and a means toward achieving a socially acceptable identity. The identities of "junkie" and "mother" placed women in a state of perpetual tension and conflict as manifested in issues of child custody and welfare. Maintaining relationship with their children was central to the women's moral identity, be it based in daily interaction or visitations inspiring hopes for a future. This ethnography suggests that IV drug users, while chemically dependent, maintain a sense of agency. Contrary to stereotypes of irresponsibility, users are reflexive about their habit's control and their use of drugs to block suffering, social responsibility, and the pain they cause others. Displays of agency and exercises of control proved critical in identity construction, particularly for women users diagnosed HIV positive. Documented was the process whereby they redefined their "health" and moral identity in the company of others who assisted in constructing identities in contrast to the negative stereotypes of AIDS. Through discourse within these "life narrative groups" a positive diagnosis was transposed into a positive identity.