The worried well: ten years of a new face for an old problem

Psychological interventions in infection with the human immunodeficiency virus

BACKGROUND

Infection with the human immunodeficiency virus (HIV) is associated with substantial psychiatric morbidity. This paper summarises the main forms of psychological intervention currently used, and reviews research evidence for their efficacy.

METHOD

Publications on the mental health aspects of HIV infection and psychological interventions were identified through the main HIV journals and general psychiatric and psychological periodicals, with the assistance of AIDS Abstracts.

RESULTS

Publications concerned psychological interventions at the time of HIV testing, interventions for infected people at different stages of disease, and risk-reduction interventions. While many publications were identified describing uncontrolled investigations, only a few studies had involved systematic evaluative research.

CONCLUSIONS

There is a need for systematic evaluation of psychological interventions for HIV infection, in terms of both efficacy and cost.

The health needs of gay men: a discussion of the literature and implications for nursing

Although there is a general dearth of nursing literature on health issues specific to gay (homosexual) men, the literature reviewed shows that gay men have particular concerns related to anti-homosexual feelings anticipated and experienced from health professionals. The effects of homophobia in wider society may cause high levels of emotional distress in some gay men, which is associated with a higher incidence of substance misuse, parasuicide, bipolar psychiatric disorders and depression. Gay men also have specific needs with regard to general medical problems, including hepatitis, HIV infection and some other sexually transmitted diseases. Gay men may also present to health services for a wide range of general medical, surgical and mental health problems. Some specific health needs are discussed: general health, sexual health and bereavement counselling. These issues may affect individuals differently through various stages in the lifespan, and nurses should be cognizant of them during their assessment of client needs. Minimum counselling skills, together with appropriate training about gay issues, are required if nurses are to deal effectively with clients' needs.