Effect Of Counseling On The Psychological Adjustment Of People Living With HIV/AIDS

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Effect Of Counseling On The Psychological Adjustment Of People Living With HIV/AIDS


Abstract


The human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) epidemic is in its third decade and has reached to alarming proportions worldwide. According to the Centers for Disease Control and Prevention, more than one million people are living with HIV with an estimated 56,300 infections happening each year in the United States. Diagnosis of HIV/AIDS via early testing along with pretest and post-test counseling is important for psychosocial stabilization and destigmatization. Risk reduction counseling as a preventive counseling method is equally important in high-risk individuals such as adolescents, substance abusers and in gay and bisexual population. The purpose of this review is to address a number of counseling strategies used for education and counseling of individuals at risk of getting HIV/AIDS and also among those who are HIV-infected


Chapter One


Introduction

1.1 Background of the Study

HIV/AIDS has become a threat to public health in Nigeria as a result of its devastating consequences, which are manifested in forms of prolonged sickness, deaths and increase in number of orphans and widows/widowers. Nigeria has an estimated population of about 150 million of which about 3.5 million are infected by HIV/AIDS (FMINO, 2007). HIV/AIDS was first identified in Nigeria in 1985 and reported at an International Conference in 1986 (Adeyi et al, 2006). The HIV/AIDS pandemic led to the death of 170,000 Nigerians in 2007 (UNAIDS, 2008). According to Edewor (2010), Nigeria has already surpassed the 5 percent explosive prevalence phase and the disease has killed more than 1.3 million people and orphaned more than 1 million children (FMINO, 2007). The infection rates of HIV/AIDS vary across the six geopolitical zones of Nigeria. According to Edewor (2010), the mode of HIV transmission in Nigeria is mainly through unprotected sex, and other factors which contribute to the spread of the virus include poverty, Sexually Transmitted Infection (STI), social and religious norms and political and social changes (National AIDS/STD Control Programme, 1999). Parke and Aggleton (2007) noted that negative social attitudes toward marginalised populations, policies mandating the testing of high risk groups and limited legal protections based on HIV status may exacerbate stigma. They stressed further that increase vulnerability to discrimination complicates the social and psychological adjustment of Persons Living With HIV/AIDS (PLWHA). The victims require necessary assistance to be able to live happily and contribute meaningfully to the development of the society. Thus, they need psychosocial supports to be able to cope with their challenges. Psychosocial needs can be described as social, mental and spiritual requirements of PLWHA in order to live quality life and contribute to development of the society. The needs can be viewed from a psychological theory propounded by Abraham Maslow in 1943. According to Maslow (1954), the hierarchy of needs is often portrayed in the shape of a pyramid, with the largest and most fundamental levels of needs at the bottom, and the need for selfactualization at the top. The most fundamental and basic four layers of the pyramid contain what Maslow called “deficiency needs” or “d-needs”, esteem, friendship and love, security, and physical needs. With the exception of the most fundamental (physiological) needs, if these “deficiency needs” are not met, an individual’s body gives no physical indication but the individual feels anxious and tense. Maslow’s theory suggests that the most basic level of needs must be met before an individual strongly desires (or focuses motivation upon) the secondary or higher level needs. Maslow also coined the term “Meta-motivation” to describe the motivation of people who go beyond the scope of the basic needs and strive for constant betterment. “Meta-motivated” people are driven by B-needs (Being Needs), instead of deficiency needs (D-Needs)(Wikipedia, 2011). For the purpose of this study, the psychosocial needs adopted comprise physiological needs, safety needs, belongingness needs, esteem needs, aesthetic needs and self-actualization as propounded by Maslow. Physiological needs include food, air and water; safety needs involve housing and security; belongingness implies social interaction and group affiliation; esteem needs involve high regard for self and others; aesthetic needs deal with love of beauty while self-actualization involves becoming what one desires to be in life.Since the discovery of HIV/AIDs in the 1980s, more than 20 million people have died from the disease. The disease killed three million people in 2003 and is now the leading cause of death and lost years of productive life for people aged ranging from 15 to 59 worldwide (WHO Report, 2004). HIV/AIDS epidemic has become a worrisome phenomenon and individual carrier of the infection suffers from several mental health consequences. The infection is associated with enormous trauma of which stigma and discrimination against people living with HIV/AIDS remain the major psychological stresses. It is perhaps no news that HIV/AIDS patients suffer from psychosocial and neuropsychiatric problems even their health care workers sometimes develop burn-out syndrome that is characterized by emotional distress, lowered job productivity and spread of work problems to family and conjugal relationships. The potential impact of stigma and discrimination has been of ongoing concern to counselors and agencies involved in addressing the HIV/AIDS epidemic. Discrimination at individual, community and national levels have major implications for the epidemic, as divides or separation is created between those who are vulnerable to infection and those who are not. Stigmatization in any magnitude has multiple effects on the lives of people living with HIV/AIDS and more broadly on members of society, creating disruptions in social functioning, and increasing people’s vulnerability to infection and reducing the overall caring capacity of communities. Stigma is perhaps a pervasive problem that affects health globally, threatening an individual’s psychological and physical well-being. HIV/AIDS epidemic has significant effect on the economic and sociological wellbeing of victims. The psychological aftermaths of HIV test mostly if positive prevent majority of the people in Nigeria and Yakurr Local Government area in particular to be tested. As such, counseling of people living with HIV and how to deal with the psychological as well as the social effects of the infection in the area remains a challenge to counselors and corporate bodies alike. However, the problem of how best to counsel infected people is perturbing especially with the rate at which HIV and AIDS are spreading in the state.


1.2 Statement of the Problem

HIV/AIDS has become a threat to public health in Nigeria as a result of its devastating consequences, which are manifested in forms of prolonged sickness, deaths and increase in number of orphans and widows/widowers. Nigeria has an estimated population of about 150 million of which about 3.5 million are infected by HIV/AIDS (FMINO, 2007). HIV/AIDS was first identified in Nigeria in 1985 and reported at an International Conference in 1986 (Adeyi et al, 2006). The HIV/AIDS pandemic led to the death of 170,000 Nigerians in 2007 (UNAIDS, 2008). According to Edewor (2010), Nigeria has already surpassed the 5 percent explosive prevalence phase and the disease has killed more than 1.3 million people and orphaned more than 1 million children (FMINO, 2007). The infection rates of HIV/AIDS vary across the six geopolitical zones of Nigeria. It is in this respect that the researcher intend to investigate the effect of counseling on the psychological adjustment of people living with HIV/AIDS.


1.3 Objective of the Study

The main objective of this study is to ascertain the effect of counseling on the psychological adjustment of people living with HIV/AIDS in Nigeria. But for the successful completion of the study the researcher intend to achieve the following objective;

  1. To ascertain the effect of counseling on the psychological adjustment of HIV/AIDS patient
  2. To investigate the relationship between counseling and psychological adjustment of HIV/AIDS patient in Nigeria
  3. To ascertain the impact of counseling on the psychological well-being of HIV/AIDS patient.
  4. To investigate the role of counseling on the life span of people living with HIV/AIDS

1.4 Research Hypotheses

For the success completion of the study, the following the research hypotheses are formulated by the researcher;

  1. H0: there is no significant relationship between counseling and psychological adjustment of people living with HIV/AIDs in Nigeria
    H1: there is a significant relationship between counseling and the psychological adjustment of people living with HIV/AIDs in Nigeria
  2. H0: counseling does not have any significant effect on the psychological adjustment of people living with HIV/AIDs in Nigeria
    H2: counseling does have a significant effect on the psychological adjustment of people living with HIV/AIDs in Nigeria.

1.5 Significance of the Study

It is believed that at the completion of the study, the findings will be of great importance to HIV/AIDs patient in the country as the study seek to enumerate the benefit of counseling to the general well-being of the
Patients, the study will also be of benefit the medical practitioners and the employees of Centers for Disease Control and Prevention, as the study laid emphasis on the benefit of counseling and guidance on the life span of HIV/AIDs patient in the country. The study will also be useful to researchers who intend to embark on research in similar topic, Finally the findings of this study will also be immense benefit to government, academia, scholars, researchers and the general public.


1.6 Scope and Limitation of the Study

The scope of this study covers the effect of counseling on the psychological adjustment of people living with HIV/AIDs in Nigeria. However, in the cause of the study the researcher encounters some constrain which limited the scope of the study;

a) Availability of Research Material:

The research material available to the researcher is insufficient, thereby limiting the study.

b) Time:

The time frame allocated to the study does not enhance wider coverage as the researcher has to combine other academic activities and examinations with the study.

c) Finance:

The finance available for the research work does not allow for wider coverage as resources are very limited as the researcher has other academic bills to cover


1.7 Definition of Terms

HIV/AIDs

Human immunodeficiency virus infection and acquired immune deficiency syndrome (HIV/AIDS) is a spectrum of conditions caused by infection with the human immunodeficiency virus (HIV). Following initial infection, a person may not notice any symptoms or may experience a brief period of influenza-like illness. Typically, this is followed by a prolonged period with no symptoms

Counseling

Counseling is the activity of the counselor, or a professional who counsels people especially on personal problems and difficulties. In order to become a licensed mental health counselor in the United States, one must hold at least a master’s or doctoral degree

Psychological adjustment

In psychology, adjustment refers to the behavioral process of balancing conflicting needs, or needs against obstacles in the environment. varied activity, or exploratory behavior accompanied by problem solving.

Infection

Infection is the invasion of an organism’s body tissues by disease-causing agents, their multiplication, and the reaction of host tissues to these organisms and the toxins they produce. Infectious disease, also known as transmissible disease or communicable disease, is illness resulting from an infection.


1.8 Organization of the Study

This research work is organized in five chapters, for easy understanding, as follows. Chapter one is concern with the introduction, which consist of the (background of the study), statement of the problem, objectives of the study, research questions, research hypotheses, significance of the study, scope of the study etc. Chapter two being the review of the related literature presents the theoretical framework, conceptual framework and other areas concerning the subject matter. Chapter three is a research methodology covers deals on the research design and methods adopted in the study. Chapter four concentrate on the data collection and analysis and presentation of finding. Chapter five gives summary, conclusion, and recommendations made of the study.


Chapter Five


Summary, Conclusion and Recommendation

5.1 Introduction

It is important to ascertain that the objective of this study was to ascertain the effect of counseling on the psychological adjustment of people living with aids.

In the preceding chapter, the relevant data collected for this study were presented, critically analyzed and appropriate interpretation given. In this chapter, certain recommendations made which in the opinion of the researcher will be of benefits in addressing the effect of counseling on the psychological adjustment of people living with HIV/AIDs in Nigeria.


5.2 Summary

There are several examples of one-on-one counseling methods used for risk reduction counseling among HIV positive individuals. The various dimensions touched upon were use of a negative approach, assessing readiness to change, and motivational enhancement therapy. Hence, we see multiple approaches used by counselors in providing education and prevention counseling to ‘at risk’ individuals and also individuals who have been infected with the virus. Internet-based counseling has gained some popularity over recent years but has to deal with issues such as lack of visual and verbal cues, confidentiality, accessibility problems by those in great need and increased client separation. Counseling related to using spiritual coping techniques have been well established in cancer literature but has limited evidence in HIV related counseling. It is mainly applicable as a psychosocial adaptation technique


5.3 Conclusion

AIDS counselling is the skill of helping people to take important decisions about life, relationships, dying and death. When the skill is well learnt it is adaptable to managing all health-related problems. The health and illness patterns of the world’s population are changing, especially with the emergence of ageing populations and increasing life expectancy. There are changes in the patterns and forms of existing diseases as well as the emergence of new ones. The orientation to health and illness has gone beyond thinking of cure as the only major motive of caring. Life involves accepting limitations and living positively within them. Counselling is caring that goes beyond curing. The issues brought to light by the needs of people with HIV and AIDS, and the people affected by their relationship to those infected, go beyond the disease itself. We are all affected; otherwise the whole world would not be talking about it. Some of the goals of counseling are to help young people understand their sexuality; to make people aware of their rights for sexual negotiation, especially where there are problems related to gender difference; to help find solutions to economic problems and to encourage an improved socio-economic status for women. As well, counselors will aim to facilitate premarital and extramarital communication, and to help in family crises which are part of HIV prevention and control. Counseling can greatly help in the problems that accompany HIV and AIDS, especially in achieving the effective communication so greatly needed to attain reconciliation with the realities of living, dying and death.


5.4 Recommendation

Based on the findings of the study the following recommendations are considered relevant: Health counselors should provide counseling services to the PLWHA and develop instruments to identify their psychosocial needs. Health counselors should encourage PLWHA to accept their conditions, identify their needs and acquire relevant skills in order to develop at t equal level with the other members of the community. Counselors and other health providers should collaborate and bring support services to the door steps of the PLWHA. This is necessary in areas of social and financial supports d. Non-Governmental Organizations, family members and other members of the community should empower PLWHA through job provision and financial support in order to assist them to meet their basic needs. Medical and other health workers should display positive attitude towards PLWHA. This can be achieved, among others, by ensuring that PLWHA are not segregated in terms of services offered to them as currently practised at the University of Ilorin Teaching Hospital.


Effect Of Counseling On The Psychological Adjustment Of People Living With HIV/AIDS


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Effect Of Counseling On The Psychological Adjustment Of People Living With HIV/AIDS


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Frequently Asked Questions


How does HIV affect mental health?

It is important for people living with HIV to know that they have a higher chance of developing mood, anxiety, and cognitive disorders. For example, depression is one of the most common mental health conditions faced by people living with HIV. It is important to remember that mental disorders are treatable.

Why is counselling important for patients with HIV?

Even with the significant medical advances in patient management, counselling remains an integral part of the management of patients with HIV, and their partners and family. Open in a separate window HANK MORGAN/SPL Figure Counselling is a core element in the care of HIV infected patients

How is the course of HIV disease influenced by patient behavior?

Important areas within the patient’s control may influence the course of HIV disease and, in any case, influence quality of life and psychological well-being. These behaviors include good nutrition, exercise, control of recreational substance use, and alterations in sexual risk behavior.

How can I get mental health support for someone with HIV?

Mental Health Providers and Programs. HIV support groups: An organized group of peers living with HIV who meet in a safe and supportive environment to provide support to other people living with HIV. Work with a trained mental health professional to learn about treatment options such as therapy and/or medicine. 

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