The Psychological and Social Needs of People with HIV/AIDS in Cyprus
The research on the Psychological and Social Needs of People with HIV/AIDS was completed in October 2007.
Contributors
Funding
- Research Promotion Foundation,
- Intercollege (Host Organisation)
End Users
Gregorios HIV/AIDS Clinic, Larnaca General Hospital, Ministry of Health, Cyprus
Scientific Coordinator
Dr Constantinos Phellas, Director of RUBSI and Associate Professor atSchool of Humanities, Social Sciences & Law, Intercollege, andDirector of RUBSI
Coordinator
Mr Costas Constantinou, Sociologist – Researcher (PhD Candidate in Social Anthropology of Health, University of Bristol, UK)
Contributors:
University of Cyprus: Dr Leontios Kostrikis, Department of Biological Sciences, University of Cyprus.
Overseas Consultant: Professor Anthony Peter Macmillan Coxon, University of Edinburgh, UK.
Background Information
The impact of antί–HIV combination therapy on the needs of people withHIV has been shaped both by changes in health and changes in prospects.A gradual shift has taken place, away from short–term needs and thepossίbίlίtίes of illness, to needs defined by the long–term and thepossίbίlίtίes of health. But needs remain highly individual – althoughimportant for some, to others this pattern of change is minor or evenirrelevant. The clinical benefits of treatment vary considerably. Manyof those who have seen major improvements in their health are now ableto meet their daily needs by themselves.
But for those coping withchronic disability or side effects, sustaining daily routines remainsdifficult.
The wider impact of combination therapy has been onperceptions of the possibilities of life. Almost everyone living withHIV now contends with an increasing range of possible futures. Ashorizons expand, needs almost always increase.
Those who risk changeface many needs, such as needs for confidence, understanding,resources, mobility, skills and friendship.But combinationtherapy is only one of many things which have shaped the needs ofpeople with HIV.
Overall, patterns of need have not changed radically,because individual needs continue to be defined by the many otherdemands of life. People with HIV are still coping with uncertainty,discrimination, anxiety, violence, loss and displacement.
People withHIV are still looking after children, seeking and sustainingrelationships, searching for trust in friendships and satisfaction insex.
People with HIV are still holding down jobs, fighting for basicrights and welfare, coping with inadequate living conditions, andmanaging dependency on drugs.
Above all, people with HIV are stillcoping with the reality of living with infection, with doubt, and withthe legacy of the past. For any individual, need is highly subjective,rooted in personal circumstances and always open to change.
Changes in need have not always been reflected in changes in demand forservices. People with HIV meet their needs by drawing on many sourcesof support – formal, informal and (above all) internal. Hence it is notalways services which feel the impact of changes in need, especiallywhen they play a relatively minor role in any individual’s life.
Furthermore, demand for services is not simply a reflection of need.People with HIV do not rationally select services to fulfill identifiedneeds. Different people gain very different things from the sameservice, regardless of what the provider is aiming to achieve. For anyindividual, Service use is a process of exploration, of working outwhat works best in dealing with the reality of life.
Changes in needhave affected service use in different ways, depending on the role ofservice use in any individual’s life.
People with HIV recognizethat services cannot do everything for them and turn to many othersources of support to deal with changes in their lives. What matters tothem is that services respect them, understand them for who they are,and attempt, as far as possible, to respond to the individuality oftheir needs.
The advent of anti–HIV combination therapies hasirrevocably changed the lives of people with HIV in the UK. The rapidchanges in HIV treatment options over the last four years have raisedhopes and expectations about the impact of treatment on the lives ofmost people with HIV.
Even those who are not taking treatment must nowassess the new possibilities which it offers, however qualified thesemay be.
Methodology
This research study would attempt toexplore the social impact of HIV and of anti–HIV combination therapieson the lives of people with HIV from a sociological and psychologicalperspective. The study would include people who are taking combinationtherapy, those who had not started therapy despite being advised to doso, and those who had stopped taking therapy.
The project’sresults would offer an opportunity to reflect on the assumptionsservice–providers make about what these people’s needs are and how theyhave been affected by the combination therapy.
There are several stepsto the analysis. Initially, every case would be considered on its ownterms, in order to identify the issues and problems specific to eachparticipant. On the basis of this analysis, a broad thematic frameworkwould be developed. This would then be used as the outline for across–case content analysis which would flesh out, challenge and modifythe individual themes within the framework.
The study adoptsboth quantitative and qualitative research methods for the betterinvestigation of the needs of people with HIV/AIDS.
More specifically:
(a) Interviews with key persons from relevant governmental and non–governmental organisations involved with HIV/AIDS.
(b)Closed questionnaires will be administered to around 100 persons withHIV/AIDS treated at the Gregorios HIV/AIDS Clinic in Larnaca.
(c) Two focus groups will be conducted with people living with HIV/AIDS.
(d) In–depth interviews with 30 persons living with HIV/AIDS.
The closed questionnaires would cover all aspects of the HIV/AIDS people’s lives, namely:
A. Accommodation / Living Conditions
B. Food/Drink
C. Sleep
D. Housework / Self–care
E. Mobility – Commuting
F. Money – Earning enough to survive
G. Stress and Depression management
H. Problems with drugs or alcohol
I. Relationships with stable partners
J. Child care
K. Friendships
L. Love life
M. Discrimination
N. Self–confidence
O. Level of knowledge on HIV treatment
P. Capability of treatment of HIV
Q. Facing health professionals
R. Education and opportunities
S. Other needs for everyday life
Both the in–depth interviews as well as the focus groups would offerthe HIV people the chance to account for their experiences with theminimal intervention on behalf of the researchers. Through theirpersonal accounts the researchers would be able to shed some light intotheir social, psychological and sexual behaviour.