SYMPTOMS AND ILLNESS BEHAVIORS OF HIV-INFECTED ADULTS

对于艾滋病毒感染者来说，由于对常见症状（如疲劳、头痛、体重变化、记忆和视力问题）有各种似是而非的解释，症状评估往往是一项令人困惑和痛苦的努力。这些解释可能包括疾病本身、药物副作用、压力、心理状态以及与药物滥用史相关的身体问题。在老年感染者中，由于与正常衰老相关的身体变化以及存在预先存在或共病的疾病，症状评估可能特别令人困惑。拟议的研究将调查老年人（50岁以上）如何解释、评估和应对常见的艾滋病毒疾病和治疗症状。具体而言，研究将集中在1)症状评估；2)症状应对反应；3)以症状缓解为目的的自我保健活动；4)症状评价对治疗接受度和依从性的影响；5)情绪和心理对常见疾病和治疗相关症状的反应。定性方法将用于收集和分析数据。将从纽约市以社区为基础的各种来源招募总共100名老年艾滋病毒感染者。研究人员和临床采访者将在两次会议中进行重点访谈和一系列标准化措施。症状评估和反应是了解的重要过程，因为它们可能影响卫生保健系统使用的适当性。它们还可能影响自我护理、对治疗方案的坚持和心理健康。所有这些都是适应这种可能成为慢性疾病的生活的重要因素，因为越来越多的人感染这种疾病后寿命更长，而且是在快速变化的卫生保健系统的背景下。

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.