The psychological and sociopolitical sequelae of HIV infection in women

Lisa Marie Frey (1993)

Women have rapidly become one of the most vulnerable groups to the AIDS epidemic, yet have been excluded from research and drug trials. A disproportionate number of women with HIV infection are from disenfranchised groups and have generally been devalued by society. There is a paucity of literature addressing the psychological consequences of HIV infection in women. The sociopolitical climate of the AIDS crisis has exacerbated further disenfranchisement and discrimination against women. Those socially dispossessed must deal with major life stressors affiliated with their devalued status in society in addition to the stigmatization and mental health issues that arise from HIV infection. A qualitative research design was utilized to interview 10 women with HIV infection representing various cultures and subcultures. Pre- and post-test counseling was either inadequate or non-existent. All immediately experienced denial, shock, numbness, and surprise in response to test results. The majority of those who had histories of addiction subsequently resorted to increased use. Denial and shock was followed by a period of depression, feelings of contagion and contamination, guilt, and fear of rejection. The women experienced multiple losses, including loss of identity, health, and relationships. All but one cited experiences of discrimination in their medical care ranging from neglect and ignorance to hostility. All of the women experienced varying degrees of personal empowerment through acquiring knowledge about HIV, developing supportive and mutually affirming connections with others, works of altruism and activism, and through a variety of individual coping skills. All stated that they would not give birth to a child given their HIV infection because of the health risks to the child. Finally, all but one of the women had experienced psychological trauma in childhood and/or adulthood raising questions of the impact of such abuse on susceptibility to behaviors that place one at risk of contracting HIV. Research to support legislation for pre- and post-test counseling certification is also recommended. Finally, the need for equal opportunities to participate in clinical trials for women and men, and the legislation of ethical delivery of medical care is stressed.