abstract antonietta mariniello

The complexity of seropositive people’s needs has brought about the necessity of developing new care strategies to deal with the many problems concerning psychological suffering, which often involve the patient’s affective context. Psychological co-morbidity in HIV patients takes on particular significance since it has a considerable bearing on the clinical evolution of the condition, on the therapeutic compliance and on the adhesion to appropriate prophylactic measures, as well as on the ability to embark on, and maintain, functional affective and sexual relations.
Since there is a constant increase in the number of cases of heterosexual HIV infection, the probability that such couples (in which one or both partners are seropositive) may require psychological assistance is also increasing. In dealing with seropositive couples, psychologists are required to face issues including difficulties relating to making plans for the future, fear of transmission and lack of spontaneity in sexual intercourse, decisions relating to pregnancy; ideas of abandonment and loss; problems relating to care; feelings of lack of confidence, sadness, guilt and anger. If on the other hand the person does not have a partner, he or she may encounter significant difficulties and even abandon the idea of entering an affective relationship, owing to embarrassment, shame, fear of infecting the other person or fear of rejection.
From a healthcare point of view, in order to aid a more effective approach to HIV infection problems, an essential requirement appears to be the planning and availability of “friendly” and open-door couple counselling services, aimed at granting psychological support and information to seropositive people and to their partners, helping couples to preserve their planning perspective, to make decisions regarding their desire for parenthood, to build and improve their affective relationship and their quality of life, and to increase their self confidence..