This study has demonstrated the complex lives of PLH in Ireland, North and South. Assessment of such complexity will naturally need to be considered carefully, to ensure that all aspects of QL of PLH are included. A number of domains have been identified that form part of the lives of PLH. Firstly, PLH can be assessed in terms of how they function in their daily lives, such as physical functioning, emotional functioning, social functioning, domestic functioning, spiritual functioning, employment functioning, financial functioning, and sexual functioning. This study found that physical, emotional and sexual functioning were severely affected in PLH. Secondly, PLH are susceptible to stigma and discrimination, and the actual or perceived stigma and discrimination has an impact on the day to day lives of PLH. The fear of stigma and discrimination onto themselves, their partners and family, significantly determines who they disclose their diagnosis to. Thirdly, how PLH respond to a HIV diagnosis and adjust to HIV illness is determined partly by their individual lifestyles, whether they are gay, IDUs or alcoholics, women, prostitutes, or whether they have existing mental illness. Such complex lifestyles contribute further to an inability of PLH to remain in paid employment, and subsequently suffer financial difficulties. Fourthly, social support varies noticeably from one PLH to another, as does the perception of what social support should entail. Furthermore, the social networks of PLH do not necessarily resemble social networks of non-HIV infected people in society. As such, while individuals may state that social support is important to them, the assessment of this requires further elucidation. Being happy and satisfied with life is important as it seems to mediate psychosocial adjustment to HIV illness.In possibly more than any other disorder, HIV illness has substantial impact on, not only the PLH, but also on spouses, family members, other relatives, work colleagues and other people in the social network. In particular there is added stress in terms of the stigma associated with HIV itself, and the associated lifestyles that PLH often live. Many PLH, because they come from ostracised micro populations, appear to have adapted to a life without traditional family support, and are thus not reliant on this traditional social support to achieve good QL and adjust well to HIV illness. In a way PLH have learnt to be self-sufficient, and exist on minimal support from a small group of people.To survive physical and emotional health crises, it was shown that PLH went through a range of emotions and behaviours when finding out that they were HIV positive. Life then progressed through complex cycles of physical and psychological battles associated with treatment for dependencies, the HIV virus and HAART. During this time, PLH attempt to take control of their life, and most PLH aim for active participation in their care and treatment. This transformational experience has been reported in adaptation to other chronic illnesses, and probably represents the adaptive ideal – the transformation from uncertainty to more certainty and control. Reflection and self-appraisal are critical elements in this dynamic process. Thus PLH see adherence to HAART as important, but dealing with their dependencies are equally or more important, in fact managing dependencies and meeting other family and social needs may be a requirement for successful HAART treatment. As such then, each individual person has to find his or her own way of living with HIV, within the constraints of HIV illness, and seeking out a future that is focused on positive living and that encompasses partners, family and friends in a non-judgemental environment.
|Number of pages||235|
|Publication status||Published (in print/issue) - 19 Apr 2010|