People with HIV have family, friends, and coworkers who will all be affected by their illness. In most communities the family is the basic unit of social organization. Families are able to survive many types of stress. Most families have dealt with death, separation, and economic hardship. HIV and AIDS place new strains on a family. Usually it can adapt, but occasionally a family breaks up when one of its members has HIV. When you sense that this is a possibility, try to help family members get the support they need to stay together. It can be useful to meet with the entire family. Family members may have questions about how to deal with HIV. You can help them talk about problems, solve conflicts, learn how to support each other, and find other sources of help from the community or government.
If a parent has HIV or AIDS, encourage her to talk about it with her chil-dren. Children often can tell that something is wrong. They may already have had one parent die of AIDS. It is important for parents to talk with their chil-dren about what to expect in the future, even if this might include becoming an orphan. Help parents make plans for their children’s future. You may want to meet with parents and children together to talk about these issues.
Coping with HIV
Denial is just one emotion that people experience when they find out they have HIV or AIDS. Most people who learn that they have a serious illness go through several emotional reactions or stages. People going through these stages may act strangely. By knowing this in advance, you will better under-stand what is happening. The most common stages of coping with an illness are described below. Not everyone will experience all of these stages, and not in the same order. However, most people will experience at least some of them during their illness, and many people will experience some of them more than once.
Stage 1. Denial and isolation: When people first hear that they have HIV, they may not believe it.
They think that you, the doctor, or the laboratory is wrong. They tell you that the test is lying. They stop listening to what you are saying about AIDS and about preventing the spread of the virus. This is true even if you are telling them something encouraging, such as the fact that they may live for many years.
Stage 2. Anger: Having a serious illness like HIV can feel unfair. People are angry that they have the disease. They ask, “Why me?” They resent the fact that others are healthy. People with HIV often feel lonely and different from the people around them who do not have the virus.
Stage 3. Bargaining: People will bargain with themselves to gain a sense of control over their destiny. They will try to stay alive to reach a goal like an anniversary, a wedding, or the birth of a child. Sometimes people will bargain with gods, spirits, or other religious figures, promising to be faithful if only they will be cured of HIV.
Stage 4. Depression: People often feel depressed about the fact that they have a serious illness.
These feelings get worse as pain and disease worsen. People feel despair about caring for their families and themselves.
Stage 5. Acceptance: Once people fully accept that they have HIV, they often find themselves with more energy and a new will to live their lives to the fullest. This can bring a sense of peace.
Supporting children with HIV
Children with HIV, even young ones, need to know that they are sick. Younger children may only need to know a little bit about HIV. Give them short, simple answers to their questions. Older children understand more and need correct information and honest answers. If they do not get this information from you or their family, they may get the wrong information from someone else. A child with HIV may suffer silently because of shame or fear. She may have problems sleeping or trouble at school. She may avoid family and friends.
Warn families about these signs and help them to talk openly with children who have HIV.
HIV and orphans
When adults with HIV die, they often leave behind children. Many parents with HIV will worry about this and try to arrange for their children to be cared for by others, but in areas where HIV is widespread, this can be difficult. For example, in Zimbabwe, a total of 150,000 children are expected to be orphaned by AIDS by the year 2000. In Zambia, this number is expected to be 600,000. One in every three families in Zambia is taking care of a child orphaned by AIDS.
If a woman has HIV, the chances are that one out of every three babies she gives birth to will have HIV. People with HIV will need help making decisions about family planning. Encourage people with HIV to talk with their partners about family planning. This is a time when giving accurate information and supporting someone with HIV will most help her.