The psychosocial impact of HIV infection--what clinicians can do to help.

The psychosocial impact of infection with human immunodeficiency virus (HIV) can be viewed from three perspectives: (1) the issues focused by acquired immunodeficiency syndrome (AIDS), (2) the persons affected, and (3) the emotions encountered. Among the many issues faced by AIDS patients, their families, and their caregivers are impending death, dependency, disfigurement, physical and emotional isolation, contagiousness, secrecy, changes in lifestyle, financial responsibility, discrimination, and burnout. Although these issues are not unique to AIDS patients, they are accentuated because more of them are likely to occur. Some ways that clinicians can help mitigate the impact of these issues are by correcting misinformation that patients and caregivers may have, improving the coordination of community services and support groups, encouraging patients to maintain control over their lives and establish a network of support contacts, being alert to repressed patient/caregiver reactions, understanding the therapeutic value of humor, and encouraging the expression of deep emotions such as grief, guilt, and anger.