SYMPTOMS AND ILLNESS BEHAVIORS OF HIV-INFECTED ADULTS

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For individuals living with HIV-disease, sympton appraisal is often a puzzling and distressing endeavor due to a variety of plausible explanations for commonly experienced symptoms (e.g., fatigue, headaches, weight changes, memory and vision problems). These explanations may include the disease itself, medication side-effects, stress, psychological states, and physical problems associated with a history of substance abuse. Among older infected adults, symptom appraisal may be especially perplexing due to the physical changes associated with normal aging and the presence of pre-existing or co-morbid illnesses. The proposed study will investigate how older (age 50 plus) individuals interpret, evaluate and respond to common HIV-illness and treatment symptoms. Specifically, the study will focus on 1) symptom appraisal; 2) coping responses to symptoms; 3) self-care activities aimed at symptom relief; 4) the influence of symptom appraisal on treatment acceptance and adherence; and 5) emotional and psychological responses to common disease and treatment- related symptoms. Qualitative methods will be used to gather and analyze the data. A total of 100 older HIV-infected individuals will be recruited from a variety of New York City community-based sources. Focused interviews and a small battery of standardized measures will be administered by the study investigators and clinican interviewers over two sessions. Symptom appraisal and response are important processes to understand since they may influence the appropriateness of health care system use. They may also influence self-care, adherence to treatment regimens and psychological well-being. All of which are important factors in adapting to life with what may become a chronic illness as more people live longer with the infection and do so within the context of a rapidly changing health care system.