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Some HIV-infected patients feel their lives have improved since their diagnosis

Infection with the human immunodeficiency virus (HIV) that causes AIDS is a chronic and debilitating condition. Yet, according to a small preliminary study, 49 percent of HIV-infected patients said that their lives were currently better than before they contracted HIV infection. Apparently, spirituality played a strong role in their perception. Patients who said that their lives were better now were more likely to say they were "at peace with God and the universe" and to have stopped using injection drugs. These feelings were unrelated to stage of HIV disease, number of years since diagnosis, or whether the patient was receiving protease inhibitor therapy.

It was not clear whether patients attributed their life improvement to HIV infection. Discontinuing illicit drug use, qualifying for social services, or some other coincident event could explain improved life satisfaction, surmises Joel Tsevat, M.D., M.P.H., of the University of Cincinnati Medical Center. With support from the Agency for Health Care Policy and Research (HS09103), Dr. Tsevat and his colleagues interviewed 51 HIV-infected patients at a regional HIV/AIDS center. Two-thirds of patients (65 percent) were already diagnosed with AIDS, one-third (31 percent) were asymptomatic, and 4 percent were symptomatic.

When asked how they felt their life was going, 71 percent of patients were mostly satisfied, pleased, or delighted; only 6 percent were mostly dissatisfied or unhappy. No patient felt that life was terrible. In addition, 41 percent of patients felt that life was staying about the same, and 47 percent felt that life was getting better. The remainder of patients felt that life was getting worse or did not know. Patients rated their health progressively worse if they had AIDS versus symptomatic or asymptomatic HIV infection. Yet on average, these patients strongly preferred longevity to excellent health. About 47 percent of patients were unwilling to trade any time in their present state of health for perfect health, and 14 percent were willing to trade, at most, 9 days of life expectancy for excellent health. These time-tradeoff scores did not differ between patients who had an AIDS diagnosis and patients who had not yet been diagnosed with AIDS.

See "The will to live among HIV-infected patients," by Dr. Tsevat, Susan N. Sherman, D.P.A., Judith A. McElwee, R.N., and others, in the August 3, 1999, Annals of Internal Medicine 131(3), pp. 194-198.

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