Adolescents With HIV: Attachment, Depression, and Adherence By Er ...

Physical and sexual developments are integral aspects of normal adolescent development, but they are more complicated for HIV-infected adolescents. The internal stress of hormonal eruptions, explosive physical growth, sexual maturation, and sexual curiosity, challenge an adolescent’s ability to feel self-assured. Physical appearance and attractiveness become a preoccupation for all adolescents (Davies, 1999). These new fascinations are particularly problematic for adolescents with HIV infection, many of whom have body lipodystrophy due to antiretroviral therapy regimens that incorporate a protease inhibitor. Adolescents with HIV infection also have the additional burden of having to be prepared to disclose their diagnosis to a potential sexual partner.

In addition to normative developmental challenges, adolescents who were born with HIV infection have had an additional set of developmental complications and considerations. Once referred to as the “AIDS babies,” they were predicted to live only a couple of years if they were lucky. No one talked about their future dreams and aspirations because they were not thought possible or realistic (Dee, 2005, section 6, cover page). Their disease had a stigma and was associated with suffering and death.

Often, their own parents embodied this stigma of shame, suffering and death, particularly when they had to face the fact that they infected their child with the virus. Eventually, the child also was faced with the knowledge that this loved, needed parent had infected him or her with the same virus, and potentially a similar fate. This certainly colored the way these children were related to by caregivers, relatives, and friends (Malee et al., 2004).

Every juncture of their development, including their attachment relationships, carries the stigma of a terrifying and life threatening disease that causes others to be frightened for them and of them (Malee et al., 2004).