4. personal construct therapy for hiv seropositive patients

#4. PERSONAL CONSTRUCT THERAPY FOR HIV SEROPOSITIVE PATIENTS TRIAL#

Family functioning goals include strengthening support, cohesion, conflict resolution and problem-solving, and establishing boundaries between the woman and drug-using individuals.

SET transforms interactions in the larger family system, and among the woman, family, and support systems outside of the family to improve the woman’s psychosocial functioning and health. Structural Ecosystems Therapy (SET Mitrani, Robinson, & Szapocznik, 2009) is a family intervention for women living with HIV or AIDS. (2003) found that a coping skills intervention for parents with AIDS and their adolescent children reduced emotional distress and problem behaviors.

#4. PERSONAL CONSTRUCT THERAPY FOR HIV SEROPOSITIVE PATIENTS TRIAL#

A recent multisite trial showed that a skill-building intervention reduced sexual risk behaviors in African American couples ( El-Bassel et al., 2010).

(2005) found improved medication adherence with a support-enhancing intervention for the seropositive partner. Two interventions for serodiscordant couples reported positive outcomes. Studies have tested dyadic family interventions with HIV-seropositive adults, in some cases reporting effects for both members of the dyad. It is important that trials of family interventions assess changes in family members in addition to changes in the identified patient ( Martire et al., 2004 Wiehs et al., 2002). Because family interventions may set in motion positive reciprocal processes among the family, they have the potential to impact family members beyond the identified patient. Recent reviews ( Campbell, 2003 Martire, Lustig, Miller, Schulz, & Helgeson, 2004 Wiehs et al., 2002) have shown that family interventions have promise, although with modest effect sizes for addressing physical health conditions. A meta-analysis of various health conditions found that adherence to treatment is 1.74 times higher in patients from cohesive families and 1.53 times lower in patients from families in conflict ( DiMatteo, 2004). Family members also experience emotional strains, and those dually affected by HIV/AIDS and substance abuse are particularly vulnerable to disruptions, such as loss of child custody ( Barroso & Sandelowski, 2004 Conners et al., 2004 Knowlton, Hua, & Latkin, 2005).įamily functioning is a predictor of physical outcomes across a spectrum of conditions ( Campbell, 2003 Wiehs, Fisher, & Macaran, 2002). Women living with HIV or AIDS have reported that family-related concerns are sources of stresses and strains ( Ndlovu, Ion, & Carvalhal, 2010) and that communication with family about illness, the family’s denial about the woman’s HIV status, their lack of knowledge about transmission, and the woman’s past drug use contribute the most stress in family relationships ( Owens, 2003). Families are a source of stress as well as support for people with HIV or AIDS and can impact medication adherence ( Merenstein et al., 2009 Murphy, Greenwell, & Hoffman, 2002) and health ( Jones, Beach, Forehand, & Foster, 2003). HIV and AIDS are a family disease ( Pequegnat & Szapocznik, 2002 Rotheram-Borus, Flannery, Rice, & Lester, 2005).

Drug use is associated with poor adherence to HIV treatments ( Ramírez García & Côté, 2003 Lucas, Cheever, Chaisson, & Moore, 2001 Sherer, 1998) and stimulant use is associated with immune activation that hastens HIV viral replication ( Carrico et al., 2008).

Women living with HIV or AIDS experience elevated psychological distress ( Bing et al., 2001 Catz, Gore-Felton, & McClure, 2002), which can have a detrimental impact on physical health ( Golub et al., 2003 Ickovics et al., 2001 Leserman et al., 2002 Remien et al., 2006). For persons living with HIV or AIDS, mental health affects HIV and AIDS disease processes. Treatment advances have transformed HIV and AIDS from mortal illnesses into manageable chronic conditions ( Cole, Hernan, Anastos, Jamieson, & Robins, 2007 Palella et al., 1998), yet together HIV and AIDS remain the fifth-leading cause of death for women in the United States, and in 2004 the leading cause of death for black women aged 25–34 years ( Centers for Disease Control, 2008).

4. personal construct therapy for hiv seropositive patients