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High Anxiety: AIDS Anxiety in the Worried-Wells and Worried-Sicks, Part One

By Bob Frascino, M.D.

September 3, 2010

Read Part Two of this blog entry, posted on Sept. 23, 2010.

Fear of an Epidemic Resulting in an Epidemic of Fear: The Worried-Wells

Imagine being so frightened of contracting an illness that you begin believing God is sending you bad omens in the form of bird poop ...

SIGNS FROM HEAVEN (BIRD TURDS AS HIV SIGN FROM HEAVEN, 2009)
Nov 11, 2009

or via commercials and advertisements ...

C'mon Bob..No more BUSHIT!!!
Mar 22, 2006

or on license plates ...

hiv 2 research
Jun 13, 2006

There are many terms for this type of irrational worrying -- AIDS phobia, AIDS panic, AIDS hysteria, AIDS anxiety, etc. The condition is comprised of three major components:

  1. Irrational fear of having acquired HIV
  2. Incorrect but strongly held beliefs as to how HIV is transmitted
  3. Bizarre attempts to avoid contracting the illness

Some American psychiatrists have suggested the acronym FRAIDS (fear of AIDS) to describe this burgeoning psychological problem among the HIV-negative worried-wells. The Body's expert forum on HIV prevention and safer sex recently began collecting some of the more extreme worried-well stories in a chapter entitled "I'm Positive I'm Positive," which can be easily accessed in the archives. Representative samples of worried wells from this chapter include:

swollen gums
Aug 17, 2010

Alqaeda brave next month
Feb 25, 2010

There are many other examples in the archives and the published medical literature, including (1) a postal worker in New York who refused to deliver mail to a public health clinic caring for HIV/AIDS patients, because he feared acquiring the disease from their letters and (2) a dude in the UK who routinely immersed his Mr. Happy and his feet in undiluted bleach after every trip to a public toilet! Public-toilet fears are quite common among FRAIDS sufferers. Here's just one of many examples, again from the archives:

Thanking You!
Nov 10, 2009

Certainly some of these irrational fears might be chalked up to ignorance. One research study of university students found 24% thought HIV could be acquired from toilet seats; 14% were convinced they could contract HIV from trying on clothes in a store; and 10% believed money handled by an HIVer was contagious! However, AIDS phobia goes well beyond routine fear associated with misinformation or myth.

Over the last nearly 30 years, since the first reports of AIDS, countless numbers of adults have experienced overwhelming and often debilitating feelings of anxiety related to HIV/AIDS. Fear itself is not a mental illness. Rather it is a normal emotional response to the perception of danger or stress. In that regard it is both instructive and protective, informing us when danger is near and preparing us to take defensive action (fight) or retreat (flight). Anxiety is a more extreme manifestation of the fear response.

Fear and anxiety are actually intricate biological mechanisms mediated through a complex cascade of neurochemical and physical reactions designed to prepare the mind and body to deal with the threat at hand. Senses sharpen; attention broadens (hypervigilance); and the heart and breathing rates quicken. The hypothalamus, pituitary and adrenal glands spring into action, quickly increasing a variety of hormones (insulin, cortisol, adrenalin, etc.) and neurotransmitters (dopamine, etc.). This is all regulated by the body's autonomic nervous system. In essence we are hardwired for anxiety!

Medically speaking there is a difference between normal fear and what is referred to as an anxiety disorder. The key element in most forms of anxiety disorders is the distortion of a person's subjective perception, resulting in the inability to discern a minor problem from a true crisis. Unchecked, distorted perceptions can trigger a vicious cycle of anxious feelings that lead to an anxiety disorder.

Distorted perceptions include:

One can easily appreciate how distorted perceptions such as these would apply to AIDS phobia.

So why do some folks develop irrational fears such as AIDS phobia while most folks just experience routine normal fear? Good question! No one is quite sure; however, researchers in this field point to four factors that increase the likelihood that a phobia will develop:

  1. Life experience: Many phobias can be linked back to real-life events that may or may not be consciously remembered. My dad, for example, has a bird phobia. He was attacked and bitten by a chicken as a toddler. AIDS phobia may develop in folks who know people who are HIV infected or who have died of AIDS.
  2. Cultural factors: Certainly religion and cultural surroundings and taboos can feed AIDS phobia. Stigma and discrimination related to HIV/AIDS continue to be prevalent. AIDS phobia folks may fear being treated the way they see HIVers being treated. That HIV/AIDS disproportionately affects gay men and intravenous drug users contributes to this problem.
  3. Genetics: As with so many other illnesses, genetics may play a role. The tendency to develop a phobia may be part of your genetic makeup. There are case reports of twins raised separately in geographically distant locations developing the same phobias. However, genetics is not the sole answer, as there are folks with severe phobias who have no relatives with the same or similar condition.
  4. Resilience, adaptability and coping skills

It's worth noting that irrational fears can have devastating consequences. The billionaire Howard Hughes developed an extreme obsessive disorder and illness phobia eventually forcing him to become a recluse. He was so afraid of getting ill that he refused contact with most people. He even refused to see doctors. When he became seriously ill, a physician was not allowed to tend to him until Hughes was unconscious and in critical condition. By then it was too late. Simple medical attention earlier could have saved his life. In essence his fear of death (thanatophobia) killed him.

Phobias

I mentioned above that AIDS phobia is far more common than most folks realize. I should also mention that phobias in general are more common than most folks realize. There are literally hundreds of phobias. In a previous blog I mentioned hippopotomonstrosesquippedaliophobia -- fear of long words. Some readers thought I was kidding. I wasn't. It really exists. Here are a few of my other favorites:

And my personal favorite: phobophobia -- fear of phobias!

Finally, I wanted to return to AIDS phobia and mention that not all AIDS phobias are incapacitating. Some are merely annoying; others actually amusing.

For instance:

  1. Arya is locked in a vicious cycle of continual HIV testing because she fears getting infected every time she gets an HIV test.

    fear for over one year
    May 1, 2010

  2. AIDS phobias and urban legends

    Please help.. (NEEDLE STICK AT A RAVE, 2010) (URBAN LEGENDS, 2010) May 23, 2010

  3. Revenge of a disgruntled baggage handler

    Toothbrush spunk follow-up question-Will donate
    Nov 8, 2009


Want to get in touch with Dr. Bob? You can reach him through his "Ask the Experts" forum, by sending a message to the Robert James Frascino AIDS Foundation, or by leaving a comment for him below. (If it's a private message, or if it includes personal info such as your e-mail address or phone number, we won't post the comment, but we will send it along to him.)

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