Coping with HIV as a chronic illness: A longitudinal analysis of illness appraisals

Abstract

Illness appraisals are central to understanding how individuals cope with chronic illness. An interpretive phenomenological approach to the analysis of two years of bimonthly stressful event narratives in a sample of 57 HIV + gay men revealed five groups that differed on how they appraised HIV and one group of individuals who changed from one type of appraisal to another over the course of the 2-year study. The ways of appraising HIV revealed in this analysis have implications for interventions and for the study of coping with HIV as a chronic illness. The repeated assessment of specific HIV-associated stressful events and a qualitative analytic approach allowed for a more in-depth understanding of the meaning of HIV for the participants. This study suggests that coping interventions may be more powerful if they are tailored to individual appraisals of HIV because different forms of coping are likely to be differentially effective depending on the meaning of HIV in the individual's life.

Keywords:

• HIV/AIDS
• appraisal
• coping
• chronic illness
• phenomenology
• narrative analysis

Acknowledgements

We are grateful to Michael Acree for his statistical support and to Susan Folkman, Michael Crosby, Mallory Johnson, and Jason Satterfield for their comments on an earlier version of this article. This work was funded by NIMH grant 61135.

Notes

Correspondence: Judith Wrubel, 1701 Divisadero Street, Suite 150, San Francisco, CA 94115, USA, 415-353-7728 and 415-353-7754, 415-353-7711. E-mail: [email protected]

Although participants were in committed relationships with healthy partners at entry into the study, over the course of the study some of the partners became ill and some of the relationships ended. Participants whose partners became ill or who ended a relationship were retained in the analyses.