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knowing of HIV positiveness and grief process
Jan 7, 1999

Hello Doctor Shernoff! I am about to finish my degree in Psychology at the University of Oporto, Portugal. I am working in supervision with additcs, and was faced with having, for the first time, to assist a pacient be transmited of his HIV positiveness. When discussinh the subject with the responsable therapist, she compared this to the grief process, and human adaptation in general. I would like to know if you agree, and woul also like to request, in your opinion, wich are the important aspects to consider, when having to communicate HIV positiveness to a heroin addict in treatment, or pacient in general. Thank you very much. Meria Carvalho, Oporto, Portugal.

Response from Mr. Shernoff

The dynamics are much more of crisis than grief upon first learning of one's being HIV positive. Eventually, weeks or months later some mourning may or may not emerge for one's illusion of immortality.

The initial work is to help the patient begin to make the psychic and practical accomodations to living with a life threatening and potentially fatal illness that is also communicable through unprotected sex and unsafe sharing of intravenous needle using paraphernalia. Part of this accomodation is to help him or her begin to become educated about HIV prevention, transmission, safer sex, safer drug use, and treatment options. This is not an easy amount of information for any person to begin to digest, especially while in the midst of a major life crisis.

This is when the mental health professional using a psycho-educational format of counseling can be enormously valuable. I do not believe that there is any great difference in how the information needs to be communicated based on the route of infection.

I hope that this is helpful. Michael Shernoff, MSW



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