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11 August 2003
Surprisingly, Life Is "Better" For Some HIV Patients
by George Atkinson

Nearly a third of patients with the AIDS virus say life is better since they received their diagnosis, according to a new study presented at the annual meeting of the Society of General Internal Medicine. The study was based on interviews with 449 HIV patients in 2002 and 2003.

According to lead researcher Joel Tsevat, a physician and researcher with the Veterans Healthcare System of Ohio and the University of Cincinnati Medical Center, the study is one of few to show that, surprisingly, many seriously ill patients are happier with life since their diagnosis. He cited anecdotal reports of this phenomenon from nurses, psychologists and other healthcare providers, but said there is little evidence of it in exisitng medical literature.

In the study, funded by the Department of Veterans Affairs and the National Center for Complementary and Alternative Medicine, patients compared their life before and after their diagnosis. About 32 percent said life was "better" since they learned they were HIV positive; 29 percent said life was "worse" 26 percent said life was "about the same" and the others said they "didn't know."

The researchers found that patients who said life had improved had reported fewer worries about finances or disclosure of their HIV status than the other patients. They expressed more optimism and greater life satisfaction, and were more likely to participate in non-organized religious activities, such as prayer, meditation or Bible study. Those who said life was better were almost equally represented among the three classes of HIV patients in the study: patients without symptoms, those with symptoms but without AIDS, and those with full-blown AIDS. About 61 percent of patients in the study had AIDS, as defined by the Centers for Disease Control and Prevention.

Tsevat said the findings jibed with those from a smaller study of HIV patients he conducted in the mid-1990s. In that study, he said, many HIV-positive patients reported "they had learned to appreciate life more than they used to. They no longer took things for granted. Things like a nice day, a change in the seasons, family they just appreciated what they had a lot more."

Tsevat's team will follow patients in the study for an additional 15 months to learn more about the factors associated with increased post-diagnosis satisfaction. A long-range goal of the research is to design and test interventions to help patients better cope with their illness.

"If we say a third of patients think life is better, what can we do for the other two-thirds, who haven't gotten to that point? Interventions might include, for example, providing more financial support or counseling for HIV patients, or referring them to chaplains for spiritual or religious guidance," said Tsevat.

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