Clicca qui per scaricare

Condividi
Il counselling psicosessuologico nelle coppie hiv-
Titolo Rivista: RIVISTA DI SESSUOLOGIA CLINICA 
Autori/Curatori: Stefano Eleuteri, Cinzia Silvaggi, Filippo Nimbi, Chiara Simonelli 
Anno di pubblicazione:  2013 Fascicolo: 2 Lingua: Italiano 
Numero pagine:  18 P. 37-54 Dimensione file:  380 KB
DOI:  10.3280/RSC2013-002002
Il DOI è il codice a barre della proprietà intellettuale: per saperne di più:  clicca qui   qui 


I più recenti dati epidemiologici sull’infezione da HIV confermano l’aumento del numero di coppie con stato sierologico discordante. Dal punto di vista psicosociale ci sono molti fattori che possono destabilizzare o rompere l’equilibrio della coppia: difficoltà ad affrontare argomenti legati alla sfera sessuale, preoccupazioni circa l’intimità, smarrimento, paura, sensi di colpa o di responsabilità, inadeguatezza, esclusione, incomunicabilità e fallimento. Questi ostacoli possono necessitare di un supporto psicologico "di coppia", soprattutto nel momento della scoperta dell’infezione, per sviluppare strategie relazionali utili. Lo scopo di questo contributo è quello di analizzare attraverso la letteratura di riferimento gli aspetti psicosessuologici nelle coppie sierodiscordanti e il ruolo che il counselling di coppia può avere, sia come strategia di prevenzione dell’HIV che come strumento di promozione del benessere relazionale e psicologico.


Keywords: HIV, coppie sierodiscordanti, counselling psicosessuologico, approccio integrato, comportamenti sessuali a rischio, salute sessuale.

  1. Sarna A., Chersich M., Okal J., Luchters S.M., Mandaliya K.N., Rutenberg N.,
  2. Allen C., Mbonye M., Seeley J., Birungi J., Wolff B., Coutinho A., Jaffar S. (2011). ABC for people with HIV: responses to sexual behavior reccomendations among people receiving antiretroviral therapy in Jinja, Uganda. Culture, Health & Sexuality, 13 (5): 529-543., 10.1080/13691058.2011.558593DOI: 10.1080/13691058.2011.558593
  3. Baeten J.M., Donnell D., Kapiga S.H., Ronald A., John-Stewart G., Inambao M., Manongi R., Vwalika B., Celum C. (2010). Male circumcision and risk of male-to-female HIV-1 transmission: A multinational prospective study in African HIV-1-serodiscordant couples. AIDS, 24 (5): 737-744., 10.1097/QAD.0b013e32833616e0DOI: 10.1097/QAD.0b013e32833616e0
  4. Bailey R.C., Moses S., Parker C.B., Agot K., Maclean I., Krieger J.N., Williams
  5. C.F., Campbell R.T., Ndinya-Achola J.O. (2007). Male circumcision for HIV prevention in young men in Kisum, Kenia: a randomised controlled trial. Lancet, 369 (9562): 643-656.
  6. Barreiro P., Castilla J.A., Labarga P., Soriano V. (2007). Is natural conception a valid option for HIV-serodiscordant couples? Human Reproduction, 22 (9): 2353-2358., 10.1093/humrep/dem226DOI: 10.1093/humrep/dem226
  7. Beyeza-Kashesya J., Kaharuza F., Mirembe F., Neema S., Ekstrom A.M., Kulane
  8. A. (2009). The dilemma of safe sex and having children: challenges facing HIV serodiscordant couples in Uganda. African Health Sciences, 9 (1): 2-12., 10.2932/51954541.331845.2009.99641DOI: 10.2932/51954541.331845.2009.99641
  9. Bunnell R.E., Nassozi J., Marum E., Mubangizi J., Malamba S., Dillon B., Kalule
  10. J., Bahizi J., Musoke N., Mermin J.H. (2005). Living with discordance: knowledge, challenges, and prevention strategies of HIV-discordant couples in Uganda. AIDS Care, 17 (8): 999-1012.
  11. Burton J., Darbes L.A., Operario D. (2010). Couples-focused behavioral interventions for prevention of HIV: systematic review of the state of evidence. AIDS and Behavior, 14 (1): 1-10., 10.1007/s10461-008-9471-4DOI: 10.1007/s10461-008-9471-4
  12. Celum C., Wald A., Lingappa J.R., Magaret A.S., Wang R.S., Mugo N., Mujugira A., Baeten J.M., Mullins J.I., Hughes J.P., Bukusi E.A., Cohen C.R., Katabira E., Ronald A., Kiarie J., Farquhar C., Stewart G.J., Makhema J., Essex M., Were E., Fife K.H., de Bruyn G., Gray G.E., McIntyre J.A., Manongi R., Kapiga S., Coetzee D., Allen S., Inambao M., Kayitenkore K., Karita E., Kanweka W., Delany S., Rees H., Vwalika B., Stevens W., Campbell M.S., Thomas K.K., Coombs R.W., Morrow R., Whittington W.L., McElrath M.J., Barnes L., Ridzon R., Corey L., Partners in Prevention HSV/HIV Transmission Study
  13. Team. (2010). Acyclovir and transmission of HIV-1 from persons infected with HIV-1 and HSD-2. The New England Journal of Medicine, 362 (5): 427-439., 10.1056/NEJMoa0904849.Epub2010Jan20DOI: 10.1056/NEJMoa0904849.Epub2010Jan20
  14. Centers for Disease Control and Prevention (2008). HIV/AIDS Surveillance Report Cases of HIV Infection and AIDS in the United States and Dependent Areas. 2006. Atlanta: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention.
  15. Church J.D., Omer S.B., Guay L.A., Huang W., Lidstrom J., Musoke P., Mmiro F., Jackson J.B., Eshleman S.H. (2008). Analysis of Nevirapine (NVP) Resistance in Ugandan Infants Who Were HIV Infected Despite Receiving Single-Dose (SD) NVP versus SD NVP Plus Daily NVP Up to 6 Weeks of Age to Prevent HIV Vertical Transmission. Journal of Infectous Diseases, 198 (7): 1075-1082., 10.1086/591503DOI: 10.1086/591503
  16. Cohen M.S., Chen Y.Q., McCauley M., Gamble T., Hosseinipour M.C., Kumarasamy N., Hakim J.G., Kumwenda J., Grinsztejn B., Pilotto J.H., Godbole S.V., Mehendale S., Chariyalertsak S., Santos B.R., Mayer K.H., Hoffman I.F., Eshleman S.H., Piwowar-Manning E., Wang L., Makhema J., Mills L.A., de Bruyn G., Sanne I., Eron J., Gallant J., Havlir D., Swindells S., Ribaudo H., Elharrar V., Burns D., Taha T.E., Nielsen-Saines K., Celentano D., Essex M., Fleming T.R., HPTN 052 Study Team (2011). Prevention of HIV-1 infection with early antiretroviral therapy. The New England Journal of Medicine, 365 (6): 493-505., 10.1056/NEJMoa1105243DOI: 10.1056/NEJMoa1105243
  17. Coldiron M.E., Stephenson R., Chomba E., Vwalika C., Karita E., Kayitenkore K., Tichacek A., Isanhart L., Allen S., Haworth A. (2008). The relationship between alcohol consumption and unprotected sex among known HIV-discordant couples in Rwanda and Zambia. AIDS and Behavior, 12 (4): 594-603., 10.1007/s10461-007-9304-xDOI: 10.1007/s10461-007-9304-x
  18. Cooper D., Moodley J., Zweigenthal V., Bekker L.G., Shah I., Myer L. (2009). Fertility intentions and reproductive health care needs of people living with HIV in Cape Town, South Africa: implications for integrating reproductive health and HIV care services. AIDS and Behavior, 13 (1): 38-46., 10.1007/s10461-009-9550-1DOI: 10.1007/s10461-009-9550-1
  19. Curran K., Beaten J.M., Coates T.J., Kurth A., Mugo N.R., Celum C. (2012). HIV-1 Prevention for HIV-1 Serodiscordant Couples. Current HIV/AIDS Report, 9: 160-170., 10.1007/s11904-012-0114-zDOI: 10.1007/s11904-012-0114-z
  20. De Angelis L., Silvaggi C. (2005). Diritti e doveri dei sieropositivi nella legislazione italiana. Rivista di Sessuologia Clinica, 12 (2): 55-66.
  21. De La Haye W., Clarke T., Lipps G., Lowe G., Longman-Mills S., Barton E., Bains B. (2010). Patterns of depressive symptoms among patients with HIV infection. The West Indian Medical Journal, 59 (4): 380-385.
  22. 21355512.
  23. Gisselquist D. (2011). HIV status in serodiscordant couples. The Lancet Infectious Diseases, 11 (9): 658-659., 10.1016/S1473-3099(11)70175-XDOI: 10.1016/S1473-3099(11)70175-X
  24. Gray R.H., Kigozi G., Serwadda D., Makumbi F., Watya S., Nalugoda F., Kiwanuka N., Moulton L.H., Chaudhary M.A., Chen M.Z., Sewankambo N.K., Wabwire-Mangen F., Bacon M.C., Williams C.F., Opendi P., Reynolds S.J., Laeyendecker O., Quinn T.C., Wawer M.J. (2007). Male circumcision for HIV prevention in men in Rakai, Uganda: a randomised trial. Lancet, 369 (9562): 657-666.
  25. Grosselin J.T., Sauer M.V. (2012). Life after HIV: Examination of HIV serodiscordant couples’ desire to conceive through assisted reproduction. AIDS and Behavior, 15 (2): 469-478., 10.1007/s10461-010-9830-9DOI: 10.1007/s10461-010-9830-9
  26. Harman J.J., Amico K.R. (2009). The relationship-oriented information-motiva- tion-behavioral skills model: a multilevel structural equation among dyads. AIDS & Behavior, 13: 173-184., 10.1007/s10461-007-9350-4DOI: 10.1007/s10461-007-9350-4
  27. Hernando V., del Romero J., García S., Rodríguez C., del Amo J., Castilla J. (2009). Reducing sexual risk behavior among steady heterosexual serodiscordant couples in a testing and counseling program. Sexually Transmitted Diseases, 36 (10), 621-628., 10.1097/OLQ.0b013e3181aac222DOI: 10.1097/OLQ.0b013e3181aac222
  28. Hunt W.K., Myers H.F., Dyche M. (1999). Living with risk. Male partners of HIVpositive women. Cultural Diversity and Ethnic Minority Psychology, 5 (3): 276-286., 10.1037/h0092586DOI: 10.1037/h0092586
  29. Kairania R., Gray R.H., Kiwanuka N., Makumbi F., Sewankambo N.K., Serwadda D., Nalugoda F., Kigozi G., Semanda J., Wawer M.J. (2010). Disclosure of HIV results among discordant couples in Rakai, Uganda: a facilitated couple counselling approach. AIDS Care, 22 (9): 1041-51., 10.1080/09540121003602226DOI: 10.1080/09540121003602226
  30. Karney B.R, Hops H., Redding C.A., Reis H.T., Rothman A.J., Simpson J.A. (2010). A framework for incorporating dyads in models of HIV-prevention. AIDS and Behavior, 14 (Suppl. 2): 189-203., 10.1007/s10461-010-9802-0DOI: 10.1007/s10461-010-9802-0
  31. Kebaabetswe P., Ndase P., Mujugira A., Sekoto T., Ntshimane M., Owor A.,
  32. Makhema J., Thior I., Essex M. (2010). Perceptions of couple HIV counseling and testing in Botswana: a stakeholder analysis. Patient Education and Counseling, 79 (1): 120-3., 10.1016/j.pec.2009.07.017DOI: 10.1016/j.pec.2009.07.017
  33. Kelly C., Lohan M., Alderdice F., Spence D. (2011). Negotiation of risk in sexual relationships and reproductive decision-making amongst HIV sero-different couples. Culture, Health & Sexuality, 13 (7): 815-827., 10.1080/13691058.2011.563865DOI: 10.1080/13691058.2011.563865
  34. King R., Khana K., Nakayiwa S., Katuntu D., Homsy J., Lindkvist P., Johansson E., Bunnell R. (2011). ‘Pregnancy comes accidentally-like it did with me’: reproductive decisions among women on ART and their partners in Uganda. BMC Public Health, 11 (1): 530., 10.1186/1471-2458-11-530DOI: 10.1186/1471-2458-11-530
  35. Mariniello A., Nardini G., Vito A., Starace F. (2003). Aspetti relazionali comportamenti di salute in coppie eterosessuali con infezione da HIV. Psicologia della Salute, 3: 91-110.
  36. McDonald K. (2011). ‘The old-fashioned way’: Conception and sex in serodiscordant relationships after ART. Culture, Health & Sexuality, 13(10): 1119-1133., 10.1080/13691058.2011.607242DOI: 10.1080/13691058.2011.607242
  37. Medley A., Garcia-Moreno C., McGill S., Maman S. (2004). Rates, barriers and outcomes of HIV serostatus disclosure among women in developing countries: implications for prevention of mother-to-child transmission programmes. Bulletin of World Health Organization, 82 (4): 299-307.
  38. Mermin J., Musinguzi J., Opio A., Kirungi W., Ekwaru J.P., Hladik W., Kaharuza F., Downing R., Bunnell R. (2008). Risk factors for recent HIV infection in Uganda. The Journal of the American Medical Association, 300 (5): 540-549., 10.1001/jama.300.5.540DOI: 10.1001/jama.300.5.540
  39. Ministero della Salute (2011). Linee Guida Italiane sull’utilizzo dei farmaci antire- HIV-1. Pavia: EDIMES.
  40. Mitchell J.W., Harvey S.M., Champeau D., Seal D.W. (2012). Relationship Factors Associated with HIV Risk Among a Sample of Gay Male Couples. AIDS and Behavior, 16: 404-411., 10.1007/s10461-011-9976-0DOI: 10.1007/s10461-011-9976-0
  41. Moreno C.L., El-Bassell N., Morrill A.C. (2009). Heterosexual women of color and HIV risk: sexual risk factors for HIV among Latina and African American women. Women & Health, 45 (3): 1-15., 10.1016/j.ijpara.2012.05.002DOI: 10.1016/j.ijpara.2012.05.002
  42. Mugo N.R, Heffron R., Donnell D., Wald A., Were E.O., Rees H., Celum C., Kiarie J.N., Cohen C.R., Kayintekore K., Baeten J.M. (2011) Partners in Prevention HSV/HIV Transmission Study Team. Increased risk of HIV-1 transmission in pregnancy: a perspective study among African HIV-1 serodiscordant couples. AIDS, 25 (15): 1887-1895., 10.1300/J013v45n03_01DOI: 10.1300/J013v45n03_01
  43. Myer L., Morroni C., Rebe K. (2007). Prevalence and determinants of fertility intentions of HIV-infected women and men receiving antiretroviral therapy in South Africa. Aids Patients Care and STDs, 2 Nattabi B., Li J., Thompson S.C., Orach C.G.1 (4): 278-285., 10.1089/apc.2006.0108DOI: 10.1089/apc.2006.0108
  44. Nattabi B., Li J., Thompson S.C., Orach C.G., Earnest J. (2009). A systematic review of factors influencing fertility desires and intentions among people living with HIV/AIDS: implications for policy and service delivery. AIDS and behavior, 13 (5): 949-968., 10.1007/s10461-009-9537-yDOI: 10.1007/s10461-009-9537-y
  45. Ndase P., Celum C., Thomas K., Donnell D., Fife K.H., Bukusi E., Delany-Moretlwe S., Baeten J.M. (2012). Outside Sexual Partnerships and Risk of HIV Acquisition for HIV Uninfected Partners in African HIV Serodiscordant Partnerships. Journal of Acquired Immune Deficiency Syndrome, 59: 65-71., 10.1097/QAI.0b013e318237b864DOI: 10.1097/QAI.0b013e318237b864
  46. NIMH Multisite HIV/STD Prevention Trial for African American Couples Group (2010a). Risky sexual behavior and correlates of STD prevalence among African American HIV serodiscordant couples. AIDS and Behavior, 14 (5): 1023-1031., 10.1007/s10461-010-9698-8DOI: 10.1007/s10461-010-9698-8
  47. NIMH Multisite HIV/STD Prevention Trial for African American Couples Group (2010b). Concordant and discordant reports on shared sexual behaviors and condom use among African American serodiscordant couples in four cities. AIDS and Behavior, 14 (5): 1011-1022., 10.1007/s10461-010-9699-7DOI: 10.1007/s10461-010-9699-7
  48. Oyesiku J.O., Turner C.F. (2002). Reproductive choices for couples with haemophilia. Haemophilia, 8: 348-352., 10.1046/j.1365-2516.2002.00625.xDOI: 10.1046/j.1365-2516.2002.00625.x
  49. Padian N.S., Shiboski S.C., Glass S.O., Vittinghoff E. (1997). Heterosexual transmission of human immunodeficiency virus (HIV) in northern California: results from a ten-year study. American Journal of Epidemiology, 146 (4): 350-357.
  50. Persson A. (2011). HIV-negativity in serodiscordant relationships: The absence, enactment and liminality of serostatus identity. Medical Anthropology, 30 (6): 569-590., 10.1080/01459740.2011.561456DOI: 10.1080/01459740.2011.561456
  51. Pinkerton S.D., Galletly C.L. (2007). Reducing HIV transmission risk by increasing serostatus disclosure: a mathematical modeling analysis. AIDS and Behavior, 11(5): 698-705. DOI 10.1007/s10461-006-9187-2. Rabkin J. (2008). HIV and depression: 2008 review and update. Current HIV/AIDS Reports, 5 (4): 163-171., 10.1007/s11904-008-0025-1DOI: 10.1007/s11904-008-0025-1
  52. Rispel L.C., Cloete A., Metcalf C.A., Moody K., Caswell G. (2012). ‘It [HIV] is part of the relationship’: exploring communication among HIV-serodiscordant couples in South Africa and Tanzania. Culture, Health & Sexuality, 14 (3): 257-268., 10.1080/13691058.2011.621448DOI: 10.1080/13691058.2011.621448
  53. Rispel L.C., Metcalf C.A., Moody K., Cloete A., Caswell G. (2011). Sexual relations and childbearing decisions of HIV-discordant couples: an exploratory study in South Africa and Tanzania. Reproductive Health Matters, 19 (37): 184-193., 10.1016/S0968-8080(11)37552-0DOI: 10.1016/S0968-8080(11)37552-0
  54. Temmerman M. (2009). Changes in sexual risk taking with antiretroviral treatment: influence of context and gender norms in Mombasa, Kenia. Culture. Health and Sexuality, 11 (8): 783-797., 10.1080/13691050903033423DOI: 10.1080/13691050903033423
  55. Shan D., Ge Z., Ming S., Wang L., Sante M., He W., Zhou J., Liu S., Wang L. (2011). Quality of life and related factors among HIV-positive spouses from serodiscordant couples under antiretroviral therapy in Henan Province, China. PLoS ONE, 6 (6): 1-6., 10.1371/journal.pone.0021839DOI: 10.1371/journal.pone.0021839
  56. Simonelli C., Fabrizi A., Rossi R., Silvaggi C., Michetti P.M. (2010). Clinical sexology. An integrated approach between the psychosomatic and the somatopsychic. Sexologies, 19 (1): 3-7., 10.1016/j.sexol.2009.03.008DOI: 10.1016/j.sexol.2009.03.008
  57. Simonelli C., Solano L. (2003). Psicologia e AIDS. Problematiche emotive del malato di AIDS e sindromi correlate. Roma: Nuova Italia Scientifica.
  58. Simpson J.A., Winterhead H.A., Rholes W.S., Oriäna M.M. (2007). Working models of attachment and reactions to different forms of caregiving from romantic partners. Journal of Personality and Social Psychology, 93 (3): 466-477., 10.1037/0022-3514.93.3.466DOI: 10.1037/0022-3514.93.3.466
  59. Starace F., a cura di (2005). HIV: aspetti psicologici e psichiatrici dell’infezione. Manuale per gli operatori. Roma: NADIR Onlus.
  60. Starace F., Mariniello A., Vito A. (2005). Sieropositività e dinamiche di coppia. In: Starace F., a cura di, HIV: aspetti psicologici e psichiatrici dell’infezione. Manuale per gli operatori. Roma: Nadir Onlus.
  61. Sullivan P.S., Fideli U., Wall K.M., Chomba E., Vwalika C., Kilembe W., Tichacek A., Luisi N., Mulenga J., Hunter E., Boeras D., Allen S. (2012). Prevalence of seroconversion symptoms and relationship to set-point viral load: findings from a subtype C epidemic, 1995-2009. AIDS, 26: 175-184., 10.1097/QAD.0b013e32834ed8c8DOI: 10.1097/QAD.0b013e32834ed8c8
  62. Thornton A.C., Romanelli F., Collins J. D. (2004). Reproduction Decision Making for Couples Affected by HIV: A Review of the Literature. Reproduction Decision Making, 12 (2): 61-68.
  63. Vitelli R., Valerio P. (2006). Virus «mentali» e virus «biologici». HIV, comportamenti a rischio di contagio ed interventi preventivi. Milano: Franco Angeli.
  64. Wagner G.J., Holloway I., Ghosh-Dastidar B., Ryan G., Kityo C., Mugyenyi P. (2010). Factors associated with condom use among HIV clients in stable rela- tionships with partners at varying risk for HIV in Uganda. AIDS and Behavior, 14 (5): 1055-1065., 10.1007/s10461-010-9673-4DOI: 10.1007/s10461-010-9673-4
  65. WHO (2006). Defining sexual health. Report of a tecnica consultation on sexual health. 28-31 January 2002. Geneva: WHO.
  66. Wyatt G.E, Longshore D., Chin D., Carmona J.V., Loeb T.B., Myers H.F., Warda U., Liu H., Rivkin I. (2004). The efficacy of an integrated risk reduction intervention for HIV-positive women with child sexual abuse histories. AIDS and Behavior, 8 (4): 453-462. DOI 10.1007/s10461-004-7329-y.

Stefano Eleuteri, Cinzia Silvaggi, Filippo Nimbi, Chiara Simonelli, in "RIVISTA DI SESSUOLOGIA CLINICA" 2/2013, pp. 37-54, DOI:10.3280/RSC2013-002002

   

FrancoAngeli è membro della Publishers International Linking Association associazione indipendente e no profit per facilitare l'accesso degli studiosi ai contenuti digitali nelle pubblicazioni professionali e scientifiche