Cognitive reorganization and stigmatization among persons with HIV

Background. A diagnosis of human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) is a life-changing event, where persons must deal with a life-threatening, debilitating disease and its associated stigma and isolation. Studies over the past decade have shown that writing and talking about stressful and traumatic experiences, such as a life-threatening illness, causes emotions surrounding the trauma to change and to become cognitively reorganized. The result is a reduction in inhibition and change in basic cognitive and linguistic processes, which have contributed to meaningful behavioural, psychological, and physical health benefits across a variety of populations. Aims. To describe the construction of the Integrated Model of Health Promotion for persons with HIV/AIDS, and present initial empirical support of the model from a feasibility pilot study of women with HIV/AIDS. Approach. The Integrated Model of Health Promotion is described and relevant literature in the field is reviewed. The model is implemented in a feasibility pilot study utilizing the emotional writing disclosure intervention. Results. Participants in the experimental condition demonstrated a promising pattern of cognitive reorganization, a reduced perception of stigma, and an improvement in mental health scores compared with the control condition. Conclusion. Implications of these findings are discussed within the framework of the Integrated Model of Health Promotion. The model explores health and behavioural benefits associated with emotional writing in individuals with HIV/AIDS. The limited sample size of this pilot study precludes testing for significance. Further studies are required prior to the development of practice guidelines.