Feelings of hopelessness in stable HIV-positive patients on antiretrovirals

Abstract

Aim. The coping skills and styles individuals utilise to deal with the stress of HIV infection greatly influence the psychological impact of this illness and potential consequent feelings of hopelessness. The aim of this study was to describe levels of hopelessness in a group of stable, non-depressed HIV-positive patients receiving antiretroviral therapy, and factors associated with hopelessness.

Method. Thirty randomly selected non-depressed patients (according to Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV) criteria) were included in this study. Demographic and other data were obtained from all subjects, who also completed the Beck’s Hopelessness Scale (BHS). The 20 true-false items of the BHS (29) measured three major aspects of hopelessness, which was interpreted on the total scale score as follows: ≤3 minimal, and >3 significant.

Results. The study population comprised 30 patients with a mean age of 37.9 years (standard error (SE) 1.18) ( range 28 - 51 years). The mean BHS score was 4.03 (SE 0.55), with a range from 0 to 12. There were no statistically significant correlations between BHS scores of the study population and gender, marital status, employment status, level of education, years since the diagnosis of HIV, or number of children (p>0.05). Eighteen subjects (60%) scored 3 or less on the BHS, considered minimal levels of hopelessness. However, 12 (40%) scored more than 3, which is considered significant; of these 23% had scores of 7 or more. There was no statistically significant association between BHS scores and gender, employment status, level of education, number of children or number of years since diagnosis (p>0.05). However, patients who were married or living with partners were statistically more likely to score higher on the hopelessness scale compared with those who were single (p<0.05).

Conclusion. Hopelessness is a psychological distress reaction that is common but largely undetected in stable HIV-positive patients on antiretrovirals. Feelings of hopelessness may result in increase in risk-taking behaviour (e.g. unprotected sex, drug use, sharing needles) and attempted suicide.