PEDIATRICS Vol. 96 No. 3 September 1995, pp. 459-463
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HIV-Infected Adolescents With Hemophilia: Adaptation and Coping

Larry K. Brown MD1, Janet R. Schultz PhD2, Rod A. Gragg PhD3, and Hemophilia Behavioral Intervention Evaluation Project

1 Rhode Island Hospital, Brown University School of Medicine, Providence, RI
2 Children's Hospital Medical Center, University of Cincinnati College of Medidne, Cincinnati, OH
3 Bradley Hospital, Brown University School of Medicine, East Providence, RI

Objective. It is estimated that 70% of individuals with factor VIII deficiency hemophilia who received blood products before 1985 are infected with human immunodeficiency virus (HIV). The goal of the current study was to assess how adolescents with hemophilia cope with reminders of their HIV status, because adaptation is likely to have implications for these individuals' quality of life and adherence to safer sex recommendations.

Methods. Participants included 297 HIV-positive adolescents with hemophilia who were recruited from 11 sites across the United States. Adolescents reported on the use and effectiveness of strategies for coping with reminders of their HIV status.

Results. A significant degree of distress was reported in response to such reminders, with anger being the most commonly reported emotion. Although a wide variety of coping strategies had been tried, participants reported using resignation (80.9%), self-calming (78.8%), and distraction (76.4%) most frequently in their attempts to cope with reminders of HIV. Self-blame (3.6%), engaging in risky behaviors (22.2%), thinking about sex (25.4%), and drug/alcohol use (29.1%) were used least. These adolescents tended to rate more active cognitive and behavioral coping strategies (eg, cognitive restructuring, seeking social support, physical activity) as most effective, whereas passive strategies (eg, wishful thinking, blaming others) were reported to be least helpful. Those individuals who reported being distressed by reminders of HIV endorsed most of the coping strategies significantly more often than the nondistressed group, although ineffective strategies were commonly chosen. Sexually active adolescents were more likely than their abstinent peers to cope by thinking about sex, engaging in risky behaviors, or using alcohol and drugs.

Conclusion. In this population of adolescents who have known their serostatus for several years, distress about everyday reminders of HIV appears to be associated with ineffective coping strategies.

Submitted on August 2, 1994
Accepted on November 23, 1994




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