BOOK REVIEW (5) ON THE FAMILY AND HIV TODAY BY ROBERT BOR AND JONATHAN ELFORD

DISCLOSURE

In the early period after testing, some people with HIV infection mourn the loss of their sexuality and see that loss as part of a downward trajectory. They resumed sex in ongoing couple relationships or found new partners. The construction of sexual activity after HIV infection involved the negotiation of a number of specific issues. Many of those seeking new relationships felt that it would be easier with another HIV-positive person. There is sex after HIV infection and it raises a number of practical issues. These practical issues are overlaid with very rich negotiations of meanings that sometimes defy a rational person model of sexual life. Safer sex is not only a practical problem with a specific solution, but also a complex negotiation about love, trust, mutuality and the erotic. Safer sex is not obnoxious but its restriction..Everything that is listed as safe sex , mutual masturbation,is not my cup of tea. Condom use is okay but he rejects the idea of doing anal intercourse a condom because condoms are not 100% safe.

Disclosing ones HIV-seropositive status to a significant other is a pivotal step toward gaining HIV-related social support. facilities coping with illness. Social support decreases the effects of stress and

Among person with HIV disease satisfaction with

informational support lessens the effect of HIV-related physical symptoms on psychological distress, and integration in social networks is related to better psychological adjustment. An additional benefit is that informing an intimate lover may lead to safer sexual practices that may stem the spread of disease. They randomly selected one primary and two alternate

patients for every one hour time block from each clinic schedule. Bothe men and women were selected however, only data on men were included in this analysis because the limited sample of woman restricted reliability. So many method they use to analyze the HIV i.e. sample recruitment, questionnaire administration, measure and statistical analysis. Those

who responded men only were grouped as homosexual; those who responded mostly men, men and women equally, or mostly women were grouped as bisexual; and who responded women only were grouped as heterosexual. Consequences of disclosure Respondents Rating of hoe their intimate lover, friend, mother and father reacted to disclosure was also examined. The men generally reported favorable reactions to disclosure. First, fathers were reported to be emotionally supportive less often than mothers, friends, and intimate lovers. Second, fathers and intimate lovers had a somewhat greater tendency to

withdraw after they were informed. Third, intimate lovers were more frequently seen as becoming angry than the other three targets. Fourth, 10.4% of respondents reported that their intimate lovers left them after they were informed. Discussion

The findings revealed that a large percentage of men who were recently diagnosed with HIV infection disclosed their seropositive status to intimate lovers and friends. Fewer had informed their mothers, brothers, or sisters, and disclosure to fathers was extremely low. One who tested HIV- seropositive I year previously and reported that they had informed their mother, disclosure could occurred at any time during that year. Disclosure should be

encouraged, among recently diagnosed asymptomatic men who may be at risk of social isolation. Counselors must consider other factors before offering recommendations

regarding disclosure. First homosexual or bisexual individuals who have not come out of their diagnosis. Second, counselors must consider the multiple motives about disclosure of HIV infection. One who affected HIV, carrying a lethal virus, they should aware the disease and should not transmissible. AIDS was associated with death, sex, misbehavior (sin), blame,

shame, rejection and stigma. The importance of secrecy / confidentially was stressed as essential to those who were worried about their infectious status. Such secrecy may seem contradictory to reducing the risk transmission. The person who knows that he/she is

infected shares this knowledge with his/her sexual partners. Such sharing of information is emotionally painful and may involve risk of being blamed and rejected. An AIDS patient

will burden their family with material needs, and need for care, as well as grief. Most AIDS patient are young adults, many are parents of small children. AIDS is a stressful disease. Emotional support involves the provision of empathy, love, trust, and caring and has a strong and consistent relationship to health status. In this disease sharing is important because it will reduce the risk of rejection or other negative social consequences. Counseling is primarily directed at meeting the psychological needs

of the infected individual and those people the individual chooses to involve in the counseling

process. Counseling may therefore need to be provided to immediate family, close friends and sexual partners. (Ministry of Health, 1989). What does the infected individual choose to involve in the counseling process? 1. The number of AIDS patients is increasing. During the process of disease

development hospital staff alone deal with their needs. The burden of care must be shared with others. 2. For material, social and emotional reasons, AIDS patients need social support. If they

affected AIDS they are afraid of rejection. 3. knowledge generated about the infected individual patterns of choice of whom to

inform about the HIV/AIDS diagnosis is of importance for improving the quality of existing HIV/AIDS counseling services and in training new counselors. 4. Such knowledge is also important for the process of involving partners and others for

prevention of further transmission. HIV/AIDS-related stigma is linked to conceptualization of sexual morality, the breaking of other taboos or other aspects of transmissible lethal disease. Piaget claimed that in authoritarian families or societies, children and instead of adhering to the older generations rules and regulations. In this study we will not deal with the roots of AIDSrelated stigma, but simply state that we think stigma and the link between sexuality and lethal disease. Accompanying the second decade of the HIV pandemic are continuing concerns about social, psychological, and behavioral aspects of the disease. Decision of persons with family members about their diagnosis. We will always keep secret this disease it may prevent potentially negative impact. Persons with HIV who are integrated in social networks have

higher levels of psychological well-being than those who are not. Which emphasize close, nurturing and supportive interpersonal relationships? Specially, two aspects of collectivismnamely, familism and simpatia. Familism promotes identification with and attachment to ones family, strong feelings of familial loyalty, and the obligation to support the family emotionally and materially. Simpatia is a a cultural script that mandates politeness, respect, and harmonious interpersonal relations. Seropositive Latinos may desire to share their HIV serostatus with significant

others as part of a sense of connectedness with family and friends.

SOCIAL SUPPORT

The universe of AIDS caregivers is not defined and we do not assume that the care givers in our sample fairly represent all caregivers. This especially true because our sample is made up largely of well educated, white gay, or bisexual man, typical identify as AIDS caregivers living in central cities. Caregivers and PWAs in our sample appear to represent a clearly defined segment of the AIDS affected community in the USA that is likely to be targeted by AIDS service agencies. AIDS support agencies are duplicative or unnecessary in most populations. Rather, it seems that much more support would be readily absorbed. In closing, we feel that the importance of support services for caregivers cannot be overstated, light of our growing understanding of the varied and far-reaching consequences of the care giving role. Future examinations of caregivers who are parents, siblings, and other traditional family members will help us gain a broader understanding of the types of support needed by HIV-affected communities.

Another important set of findings were those concerning the specific correlates of carers burden and adjustment. Correlates of carers burden and adjustment appear to be whether the carer is living with the patient, patients health, and HIV-related problems. The number of emotional and existential problems related with being HIV-infected emerged as the strongest correlate of carers adjustment. The present study also investigated the

differences in adjustment between parents and carers. It is important to emphasize that friends and family clearly want desperately to helpful and supportive to their loved ones with AIDS, but often they simply dont know how. Hopefully, the findings from this line of research can be used to provide information to counsel friends and family-to help build their support skills so they are more likely to behave in ways that truly are experienced as helpful. Bibliography Bor, Robert, Elford, Jonathan, The Family & HIV Today, London: Cassell, 1998.