Grief and HIV Medication Adherence: The Work of Transcending Loss

Abstract

Persons newly diagnosed with HIV experience diagnosis as a traumatic loss. While experiencing the grief arising from this loss, they must initiate and sustain the process of managing a stigmatized and life-threatening disease that can be effectively controlled only by consistent high-level adherence to antiretroviral medication regimens. Many patients cannot meet this challenge. Experiences of patients who have met the challenge are explored in the context of grief theory in this secondary analysis of focus group data from 24 HIV-infected gay men with high levels of medication adherence. Participants described circuitous behavioral and emotional trajectories from diagnosis to attainment of successful adherence that included working through/coping with grief, accepting their HIV-infected status, transcending loss through development of self-compassion, embracing medication adherence, and social/psychic reintegration.

KEYWORDS:

• grief
• grief-work
• HIV
• medication adherence
• self-compassion

Acknowledgments

The authors thank Elizabeth P. Flint for editorial and graphic assistance.

Additional information

Notes on contributors

John M. Brion

John M. Brion is an assistant professor of nursing at the Duke University School of Nursing in Durham, North Carolina. His research focuses on psychosocial adaptation to chronic illness, loss and grief experiences, self-compassion, and HIV.

Edna M. Menke

Edna M. Menke is an associate professor emeritus in the College of Nursing at The Ohio State University in Columbus, Ohio. Her research interests include vulnerable populations such as families living in poverty, individuals living with chronic illness, loss and grief experiences, and theory development.

Claire Kimball

Claire Kimball is a staff RN in the Surgical Trauma ICU at the Duke University Medical Center in Durham, North Carolina. Her current research interests include shame, self-compassion, resiliency, and wellness among vulnerable populations.