Knowledge of HIV/AIDS and emotional adjustment in a cohort of men with haemophilia and HIV infection: final report

This study presents the final report of a long-term psychological assessmen t of men with haemophilia and HIV infection. The knowledge, emotional impac t regarding HIV infection and prospective changes over time and the need fo r psychological support were evaluated. The study group comprised 118 men with haemophilia, 66 HIV seropositive and 52 seronegative, from the Haemophilia Centres in Bari, Florence, Milan and Naples. All subjects performed psychological tests (STAI: state and trait anxiety i nventory; SDS: self-rating depression scale) and completed questionnaires t o ascertain their knowledge and the emotional impact of AIDS. After enrolme nt (1992-93) the assessment was repeated twice over a 2-year period. A high percentage of subjects in both groups answered the questionnaire on knowle dge correctly and, more specifically, all (100%) admitted knowing that sexu al intercourse was a risk factor for HIV infection, adding that sexual part ners of haemophiliacs with HIV should be regularly tested. The percentage, however, decreased for seropositives who admitted to always using a condom during sexual intercourse (86%) and for those who declared that partners we re periodically tested for HIV (60%). The most important feature of the study is that, contrary to predicted expe ctations, seropositive and seronegative subjects presented the same degree of emotional involvement: there an no statistically significant differences in average scores between groups either on the anxiety or depression scale s. Moreover, for certain aspects, seronegatives revealed greater emotional involvement: at baseline evaluation, they felt more fear and unhappiness wi th statistically significant differences compared to asymptomatics. Further more, seronegatives more than seropositives continue to feel reluctance tow ards infusion and avoid blood products after learning of AIDS. These result s emphasize the importance of paying due attention to the emotional status of seronegatives. Their reluctance towards the use of brood products (despi te present safety) is a very important issue for the possible consequences of treatment with the risk of worsening the clinical condition. In conclusi on, we believe that counselling on HN infection/AIDS needs to address every person with haemophilia regardless of HIV status.