Psychiatric Aspects of AIDS

Abstract

The pace of the new acquired immune deficiency syndrome (AIDS) discoveries and clinical complications is such that those actively involved in AIDS clinical research might feel caught in a vortex of events, many of which appear to be out of control. During the past 9 years, since the syndrome called AIDS was first described, I have attempted to observe and understand the response of the general public and various groups to the AIDS epidemic. The experimental work on which many of these observations is based is an ongoing study of approximately 1000 gay and bisexual men at high risk of AIDS. These men comprise the Chicago cohort of a Multicenter AIDS Cohort Study (MACS), which is funded by the National Institute of Allergic and Infectious Diseases (NIAID) and the National Cancer Institute (NCI). The aim of the MACS is to describe the natural history and epidemiology of AIDS and human immunodeficiency virus (HIV), formerly known as HTLV-III or LAV-related disease. In Chicago, 95% of the MACS cohort is also participating in a National Institute of Mental Health (NIMH)-funded study of the psychosocial consequences of being at high risk of AIDS. In this chapter I present some models incorporating organizing principles to help us understand the context in which AIDS impacts on behavior. They are presented here in the hope that such organizing concepts may help us to impact in a constructive fashion on the psychological and social consequences of AIDS.