Sexual functioning is often neglected in the care of HIV-infected patients. Little information exists about the relationship between hormonal factors, psychological factors, medication, HIV disease stage and sexual functioning among persons with HIV disease. In this study, 50 HIV+ men completed the Derogatis Sexual Functioning Inventory (DSFI), and had serum hormonal assays drawn (testosterone, thyroid function test, leuteinizing hormone, prolactin and oestradiol). Although all the subjects reported some degree of sexual dysfunction, persons with symptomatic HIV/AIDS reported more negative mood, lower sexual satisfaction scores and worse body image than persons with asymptomatic HIV. Persons with asymptomatic HIV also tended to have normal testosterone levels compared with persons with symptomatic HIV/AIDS. No relationship was found between medications and low testosterone, although numbers were small. These results suggest that sexual dysfunction is prevalent among persons with HIV disease, is more common as patients become symptomatic and progress to AIDS and that both physiological (low testosterone) and psychological issues play a role.
To determine whether and how highly active antiretroviral therapy (HAART) has influenced the prevalence of pain and other symptoms experienced in persons with HIV disease, HIV+ patients at an urban outpatient clinic were asked to complete a symptom checklist before seeing a clinician. Among those who completed the checklists (N = 484), 68% reported at least one symptom and 96% of those reported more than one symptom. Almost half of this cohort reported symptoms with an intensity of 5 or greater, indicating symptoms of at least moderate to severe intensity. The most frequently experienced symptoms were fatigue, trouble sleeping, anxiety, and pain. Despite methodological limitations, the results of this survey project indicate that pain and other symptoms--though less frequent than during the pre-HAART era--continue to be a problem.
Spirituality is an important though often neglected aspect of pain in patients with human immunodeficiency virus (HIV) and/or cancer, for both patients and nurses. The spiritual domain involves: (1) meaning, (2) hope and (3) love and relatedness. The author examines spiritual aspects of pain in persons with HIV and/or cancer, as supported by the literature. Understanding spiritual aspects of pain carries implications for nursing. One of these implications is that it is important for the nurse to be closer to his/her own spirit in order to be there for the patient in pain. Other nursing implications include spiritual assessment and interventions, such as presence, attentive listening, acceptance and judicious self-disclosure, for promoting comfort and diminishing pain.
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