Sources of Emotional Distress Associated with Diarrhea Among Late Middle-Age and Older HIV-Infected Adults

Abstract

Although the experience of physical symptoms can adversely influence emotional well-being, the specific emotional reactions experienced in response to specific symptoms are not well understood. The current report examines the emotional impact of diarrhea among HIV-positive late middle-age and older adults (i.e., age 50 and over). In-depth interviews were conducted with 100 participants, of whom 29 had experienced diarrhea and spoke about the emotional impact it had had on them. Three principal themes emerged: (1) I don’t control the diarrhea, the diarrhea controls me; (2) I feel ashamed, dirty and tainted; (3) I fear what the diarrhea is doing to me and what it means. Their inability to control when and where their diarrhea would occur was a great source of emotional distress for participants. Almost all feared the possibility of fecal incontinence while out in public and the humiliation it would bring. To avoid this, many greatly restricted their time outside the home or where they would go to ensure access to a restroom. Others felt shame and perpetually “dirty” even when not dealing with a bout of diarrhea. Many also worried about the effect the diarrhea would have on their health and whether it signaled progression to end-stage disease. The data strongly support the need to aggressively manage diarrhea in HIV-infected adults as the social and emotional consequences can be profound. When it cannot be effectively controlled physicians and social service agencies should address the isolation by providing home-based opportunities for social support and interaction.

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“…These findings were similar to a recent qualitative study that reported diarrhea, one common type of GI symptom, aggravated emotional distress in older PLWH [32]. In their study, PLWH reported that the reasons for emotional distress were due to uncertainty and fear of why they were experiencing diarrhea, and shame and internalized stigma for experiencing diarrhea [32].…”

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“…The experience of stigma appeared to diminish with age, with adults 60 and older reporting significantly lower stigma scores than those aged 50–59 years (Emlet, 2007). For older adults, the fear of stigma was related to concerns about rejection and to socially problematic consequences of HIV-related symptoms, which often resulted in social isolation as people limited social contacts (Siegel, Schrimshaw, Brown-Bradley, & Lekas, 2010). …”

Factors Determining Quality Of Life of Geriatric Patients With HIV/AIDS: A Cross Sectional Study In South India

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