Coping strategies of female adolescents with HIV/AIDS

ABNF Journal, The, July-August, 2002 by Carolyn L. Lewis, Sandra C. Brown

Abstract: This descriptive study was designed to assess coping strategies of female adolescents infected with Human Immunodeficiency Virus (HIV) or the Acquired Immunodeficiency Syndrome (AIDS) (N=30). Results from the Adolescent Coping Orientation for Problem Experiences Questionnaire (ACOPES) revealed that the most often utilized coping strategies identified by the adolescents were: listening to music, thinking about good things, making your own decisions, being close to someone you care about, sleeping, trying on your own to deal with problems, eating, watching television, daydreaming and praying. The adolescents also reported low utilization of certain maladaptive coping strategies such as alcohol and illicit drug usage.

Chronic illnesses such as HIV, cancer and diabetes are difficult for adolescents because of the unique developmental tasks needed to understand the psychological and social impact caused by chronic illnesses. The research presented illustrates the complexities of stress and the effects of coping on psychological well-being, health behavior, and health. This research explores specific coping strategies used by HIV-infected adolescents.

Findings provided baseline data of the various coping strategies of female adolescents infected with HIV in an outpatient setting. These findings may serve as a foundation for future studies on coping strategies among females infected with HIV. Furthermore, the findings may also be useful in developing an outpatient behavior-modification/ coping effectiveness training program that is both gender-specific and culturally appropriate.

Key Words: Coping Strategies, Female Adolescents, HIV/ AIDS

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Adolescents and young adults represent one of the fastest growing segments of the population to acquire HIV in the United States. In 2000, 1,688 young people (ages 13 to 24) were reported with AIDS, bringing the cumulative total to 31,293 cases of AIDS in this age group (CDC, 2001). In 2000, among young women aged 13 to 24 years, 45% of all AIDS cases reported were acquired heterosexually and 11% were acquired through injection drug use. These data also show that even though AIDS incidence (the number of new cases diagnosed during a given time period, usually a year) is declining, there has not been a comparable decline in the number of newly diagnosed HIV cases among youth. Cumulatively, young African Americans are most heavily affected, accounting for 56% of all HIV cases ever reported among 13- to 24-year-olds (CDC, 2001).

Adolescents are particularly vulnerable to HIV infection because of the increase in high risk sexual behavior. High risk behavior is amplified by the adolescent's sense of invulnerability. HIV infection represents a real and immediate threat to adolescents who engage in high risk behavior activities such as recreational drug use and unsafe sexual behavior. Therefore, there is a growing need for the adolescent population to learn coping strategies that may be useful in reducing the psychological distress of living with HIV/ AIDS.

Heterosexual contact has accounted for the largest exposure category among HIV-infected cases in adolescent and adult females younger than 25 years of age (CDC, 2001). It is the most common mode of transmission in women globally. In the United States, the African American heterosexual woman continues to be the fastest growing group of persons with AIDS (Brown, 2001). Female anatomy, physiology, and sexual practices contribute to increasing risk of transmission, although there are no major biomedical differences in development of the disease related to gender (Gaskins, 1999). Schoeberlier, Belzer, & Woolston, (1999) reported that many adolescent girls equate sex with love and/or peer acceptance and suffer undesirable consequences as a result of their actions such as HIV-infection, other sexually transmitted diseases and pregnancy. For these reasons adolescent relationships are often both emotionally and physically risky. This at risk behavior may lead to heterosexual HIV transmissions among female adolescents.

Shifting of the HIV/AIDS epidemic to younger age groups necessitate the need to identify coping strategies used by adolescents with HIV/AIDS in order to support them. To date, there is a paucity of research on the coping strategies of adolescents with HIV/AIDS. To address this deficit, a pilot study was conducted to examine coping behaviors of thirty HIV-infected female adolescents between 13 and 21 years of age.

The following research questions were addressed:

1. What are the coping strategies of HIV-infected female adolescents?

2. What factors enhance adaptive coping strategies in HIV-infected female adolescents?

3. Is there a difference in coping styles between HIV-infected female adolescents living at home compared to HIV-infected female adolescents not living at home?

REVIEW OF LITERATURE

Coping

Coping is defined as the things people do to master, tolerate, and minimize life strains or demands. Coping is "a constantly changing process involving cognitive and behavioral efforts deployed to manage specific external and or internal demands that are appraised as stressful" (Lazarus & Folkman, 1991, p. 141). Coping is also defined as a process by which an individual manages the ever-changing environment (McFarland & McFarland, 1993). Coping may be seen as actions taken by persons directed at confronting demands, solving problems, and/or altering and managing stressors (MuCubbin, Thompson, & McCubbin, 1996). Coping behavior is generally influenced by maturation and cognitive development such as increasing attention span, problem-solving ability, and understanding peers and adults (Berk, 1994).