Clinical and Epidemiological Aspects of the Internal Picture of Disease in HIV-Positive Patients

Aim. Study the Structure of the Internal Picture of Disease in HIV-Infected Patients Depending on Clinical and Epidemiological Characteristics.

Materials and methods. 86 HIV-infected patients aged 19 to 59 years were examined, with varying duration of infection and severity of disease progression. The pilot study was conducted at the Kuzbass AIDS Center. Research methods: questionnaire "Short questionnaire of E. Broadbent disease perception in Russian adaptation; "Personal meaning of the disease" (Z.L. Lipowski); "Emotional Response Questionnaire"; Student's t-test for independent samples; descriptive statistics; factor analysis was performed by principal component method by Varimax rotation taking into account Kaiser test; cluster analysis. As part of the study, the results of studies of the subjective response of the individual to HIV infection as a chronic incurable life-threatening disease are systematized.

Results. The study systematized research findings on subjective responses to HIV infection as a chronic, incurable, life-threatening disease. The internal picture of disease in HIV-positive patients is determined by disease severity. The duration of infection correlates with cognitive assessment of disease threat but has less impact on subjective response. Cognitive assessment aligns with HIV infection severity. In patients in remission with over 10 years of infection, the cognitive level of the internal picture of disease (IPD) dominates. Emotional representations show ambivalence (self-stigmatization combined with hope, optimism, and joy from overcoming difficulties). The motivational-meaning level of IPD is characterized by predominance of positive personal meanings. In patients with progressive forms of HIV infection, regardless of infection duration, all IPD components reflect acute stress impact. Emotional level of IPD shows depression (despair and helplessness as leading emotions). Negative personal meanings dominate («disease as threat», loss of health, weakness).

Conclusion. The severity of disease progression and cognitive assessment of HIV infection influence the development of different variants of the internal picture of disease. The unique adaptation pattern of people living with HIV in remission (with high ART adherence, undetectable viral load, and long disease history) is characterized by belief in disease controllability as the leading adaptive resource in the IPD structure.

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