A Multidimensional Conceptual Framework for Understanding HIV/AIDS As a Chronic Long-Term Illness‪.‬

Cassandra is a 29-year-old single woman of Asian descent with a history of substance abuse and depression. Five years ago, while hospitalized with pneumonia, she learned that she was HIV positive and that her immune system was already significantly compromised. Initially devastated by this news and in denial, she began antiretroviral medication three months after her doctor recommended it. Although she has some unpleasant side effects from these medications, she is generally responding quite well. She has had no HIV-related illnesses since that initial episode of pneumonia, and she is now in recovery from her drug use. Last year Cassandra started dating and wanted to pursue a more intimate relationship with her partner, a man for whom she had very strong feelings. However, fearing the risk of transmitting HIV to him, she ended the relationship. She now seeks the help of a social worker because she is feeling depressed and anxious about her future. As this case study illustrates, HIV can affect clients, families, and communities in numerous and complex ways. Although most social workers may have some knowledge about HIV, many lack adequate understanding of the contexts and processes of HIV, particularly in light of treatment advances (Gillman, 1991; Wolf, 2000; Zibalese-Crawford, Brennan, & Stein, 1995). Unfortunately, this misunderstanding can result in inappropriate care and increased distress for the person with HIV and his or her support system.