Brown L K, Schultz J R, Gragg R A
Rhode Island Hospital, Brown University School of Medicine, Providence 02903, USA.
Pediatrics. 1995 Sep;96(3 Pt 1):459-63.
It is estimated that 70% of individuals with factor VIII deficiency hemophilia who received blood products before 1985 are infected with human immunodeficiency virus (HIV). The goal of the current study was to assess how adolescents with hemophilia cope with reminders of their HIV status, because adaptation is likely to have implications for these individuals' quality of life and adherence to safer sex recommendations.
Participants included 297 HIV-positive adolescents with hemophilia who were recruited from 11 sites across the United States. Adolescents reported on the use and effectiveness of strategies for coping with reminders of their HIV status.
A significant degree of distress was reported in response to such reminders, with anger being the most commonly reported emotion. Although a wide variety of coping strategies had been tried, participants reported using resignation (80.9%), self-calming (78.8%), and distraction (76.4%) most frequently in their attempts to cope with reminders of HIV. Self-blame (3.6%), engaging in risky behaviors (22.2%), thinking about sex (25.4%), and drug/alcohol use (29.1%) were used least. These adolescents tended to rate more active cognitive and behavioral coping strategies (eg, cognitive restructuring, seeking social support, physical activity) as most effective, whereas passive strategies (eg, wishful thinking, blaming others) were reported to be least helpful. Those individuals who reported being distressed by reminders of HIV endorsed most of the coping strategies significantly more often than the nondistressed group, although ineffective strategies were commonly chosen. Sexually active adolescents were more likely than their abstinent peers to cope by thinking about sex, engaging in risky behaviors, or using alcohol and drugs.
In this population of adolescents who have known their serostatus for several years, distress about everyday reminders of HIV appears to be associated with ineffective coping strategies.
据估计，1985年前接受血液制品的70%的血友病A患者感染了人类免疫缺陷病毒（HIV）。本研究的目的是评估血友病青少年如何应对其HIV感染状况的提示信息，因为适应情况可能会对这些个体的生活质量及坚持安全性行为建议产生影响。
参与者包括从美国11个地点招募的297名HIV阳性血友病青少年。青少年报告了应对其HIV感染状况提示信息的策略的使用情况及有效性。
对于此类提示信息，报告显示有显著程度的痛苦，愤怒是最常报告的情绪。尽管尝试了多种应对策略，但参与者报告称，在应对HIV提示信息时，他们最常使用听天由命（80.9%）、自我平静（78.8%）和分散注意力（76.4%）的方法。最少使用自责（3.6%）、从事危险行为（22.2%）、思考性（25.4%）以及使用药物/酒精（29.1%）的方法。这些青少年倾向于将更积极的认知和行为应对策略（如认知重构、寻求社会支持、体育活动）评为最有效，而消极策略（如意愿性思维、责备他人）被报告为最无帮助。那些报告因HIV提示信息而痛苦的个体比无痛苦组更频繁地认可大多数应对策略，尽管通常选择的是无效策略。性活跃的青少年比禁欲的同龄人更有可能通过思考性、从事危险行为或使用酒精和药物来应对。
在这群已知自身血清学状态数年的青少年中，日常HIV提示信息带来的痛苦似乎与无效的应对策略有关。
