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debilitating as to keep the patient from presenting in a clinical setting. Other physical
manifestations may include a wasting syndrome and Kaposi’s sarcoma. These ill-
nesses may be the focus of the individual’s complaints.
These issues can be dealt with in the traditional supportive fashion. Referrals to a
physician familiar with the AIDS/HIV spectrum illness are appropriate. Supportive,
directive therapy with case management referrals can be most useful. Patients are fre-
quently so debilitated as to require full social service interventions, including trans-
portation arrangements, food and hygiene vouchers, supplementary income support
and housing arrangements.
The Centers for Disease Control have defined AIDS in the following manner:
Aids is a disabling or life-threatening illness caused by the Human Immunodeficiency
Virus (HIV) characterized by HIV Encephalopathy, HIV Wasting Syndrome, or certain
conditions due to immunodeficiency in a person with laboratory evidence for HIV
infection or without certain other causes of immunodeficiency.
This definition encompasses the existing criteria of 23 clinical conditions as well as
any of the following conditions:
• CD4 T-lymphocyte count of fewer than 200 cells per cubic millimetre
• pulmonary tuberculosis
• recurrent pneumonia (within a 12-month period)
• invasive cervical cancer.
As can be noted, the primary definition rests on the development of an oppor-
tunistic infection, or the lack of TC4 cells. Both of these operational definitions are
focused on the body’s immune system.
HIV vs AIDS
The contention of this paper is that within a single terminal disease continuum there
exist at least two distinct, discrete disease processes. Each of these processes provides
a unique challenge for the medical and psychological treatment community. Within
each proposed disease entity there exists a unique set of circumstances to be dealt
with in a multitude of treatment spheres. This paper divides each of the diseases into
two distinct realms of physiological and psychological solely for a teaching purpose.
In reality, the two are inexorably intertwined, one affecting the other. As the cate-
gories can be divided into two entities, the interventions can be divided into collateral
sets of interventions. However, this may be only a pedagogical device to assist in the
conceptualization of the disease process and interventions.
In the initial HIV process the psychological interventions take prominence. That
is not to diminish the importance of the physiological interventions. As the face of
the virus changes, medication protocols are being updated on a monthly basis. It is
incumbent on the practitioner to be well versed in current treatment trends. When
the individual initially becomes aware of their seroconversion to HIV-positive status
the interventions frequently become those of a ‘crisis intervention’ model.
A confirmed diagnosis of seropositivity or asymptomatic HIV disease represents a
‘crisis opportunity’: it tends to impair the patient’s functioning while at the same time
heightening ongoing issues and presenting new incentives for furthering behavioural
and emotional change. It is possible that by resolving the emotional crisis, the individ-
ual may be able to develop coping resources that may be used in the future.
Hypnosis and HIV/AIDS
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