The Interface of Attachment Relationships and theImplicit and Explicit Expressions of Spirituality among Older Men Living with HIV/AIDS as a Chronic Illness
From the early 1980s when the first cases of HIV/AIDS were diagnosed, until the 1990s when the antiretroviral therapies became available, a person who contracted HIV/AIDS faced the prospect of an almost certain and painful debilitating death. With the development of the antiretroviral therapies, many persons once destined to die from AIDS had the possibility of surviving AIDS. These persons find themselves adjusting to the prospect of living with a life-limiting chronic illness. In 2007, the Center for Disease Control estimated that adults over 50 comprised 24% of persons diagnosed with HIV in the United States, and of these adults, 72% were men. This narrative qualitative study investigated the interface of attachment relationships and the implicit and explicit expressions of spirituality among seven older men, residing primarily in the District of Columbia Metropolitan area and living with HIV/AIDS as a chronic illness. Using semi-structured, in-depth, multiple interviews of each participant, a narrative was constructed highlighting the early awareness and diagnosis of HIV/AIDS, the adjustment to living with HIV/AIDS, and the meaning attributed to this experience. The data was chronologically organized into significant events and then analyzed by using Murray`s four levels of analyzing health narratives: the positional (social standing of investigator and participant); the personal (perceptions of the participant); the ideological (cultural beliefs in which the story takes place); and the interpersonal level (dynamic interchange between investigator and participant). Attachment relationships and the relationship with spirituality were emphasized to determine the role of spirituality in their lives. This research produced two major findings. First, attention to the implicit expressions of spirituality was critical to understanding the role of spirituality in these men`s lives. Second, the medical doctor served as a significant attachment figure for these men. As transition from life with a terminal illness to a chronic illness becomes more prevalent due to medical discoveries and breakthroughs in treatments, information from this study may increase the competence and inform the interventions of social workers providing services to people coping with the illness of HIV/AIDS.
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