Journal of Behavioral Medicine

, Volume 26, Issue 2, pp 165–181 | Cite as

AIDS-Related Grief and Coping with Loss Among HIV-Positive Men and Women

  • Kathleen J. SikkemaEmail author
  • Arlene Kochman
  • Wayne DiFranceisco
  • Jeffrey A. Kelly
  • Raymond G. Hoffmann


AIDS-related grief was examined and its association with coping among HIV-positive men and women explored. AIDS-related grief, psychological distress and coping were examined among a sample of 268 HIV-infected individuals, diverse with respect to gender, ethnicity, and sexual orientation. Participants exhibited elevated scores on measures of grief reaction and psychological distress including depressive symptoms, anxiety, and traumatic stress related to their losses. Hierarchical regression analyses revealed that severity of grief reaction was associated with escape-avoidance and self-controlling coping strategies, type of loss, depressive symptoms, and history of injection drug use. Interventions are needed to enhance coping and reduce psychological distress associated with the unique bereavement experienced by people living with HIV- and AIDS-related grief.

HIV/AIDS grief bereavement coping 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. Antoni, M. H., Goldstein, D., Ironson, G., LaPerrier, A., Fletcher, M. A., and Schneiderman, N. (1995). Coping responses to HIV-1 serostatus notification predict concurrent and prospective immunologic status. Clin. Psychol. Psychother. 2: 234–238.Google Scholar
  2. Beck, A. T., and Steer, R. A. (1993). BDI: Beck Depression Inventory Manual, Psychological Corporation, New York.Google Scholar
  3. Belsley, D. A., Kuh, E., and Welsch, R. E. (1980). Regression Diagnostics: Identifying Influential Data and Sources of Collinearity, Wiley, New York.Google Scholar
  4. Centers for Disease Control and Prevention (2001). HIV/AIDS–United States, 1981–2000. MMWR 50: 430–434.Google Scholar
  5. Cohen, S., Mermelstein, R., Kamarck, T., and Hoberman, H. (1985). Measuring the functional components of social support. In I. Sarasan and B. Sarason (Eds.), Social Support: Theory, Research and Applications. Dordrecht: Martirus Nijhoff Publishers.Google Scholar
  6. Deeks, S. G., Smith, M., Holodniy, M., and Kahn, J. O. (1997). HIV-1 protease inhibitors: A review for clinicians. JAMA 277: 145–153.PubMedGoogle Scholar
  7. Folkman, S., Chesney, M., Collette, L., Boccellari, A., and Cooke, M. (1996). Postbereavement depressive mood and its prebereavement predictors in HIV+ and HIV- gay men. J. Pers. Soc. Psychol. 70: 336–348.PubMedGoogle Scholar
  8. Folkman, S., and Lazarus, R. A. (1988). Manual for the Ways of Coping Questionnaire: Research Edition, Consulting Psychologists Press, Palo Alto, CA.Google Scholar
  9. Goodkin, K., Blaney, N. T., Feaster, D. J., Baldewicz, T., Burkhalter, J. E., and Leeds, B. (1999). A randomized controlled clinical trail of a bereavement support group intervention in HIV type 1–seropositive and-seronegative homosexual men. Arch. Gen. Psychiatry 56: 52–59.PubMedGoogle Scholar
  10. Horowitz, M. J., Wilner, N., and Alvares, W. (1979). Impact of event scale: A measure of subjective stress. Psychol. Med. 41: 209–218.Google Scholar
  11. Ickovics, J. R., Druley, J. A., Morrill, A. C., Grigorenko, E., and Rodin, J. (1998). “A grief observed”: The experience of HIV-related illness and death among women in a clinic-based sample in New Haven, Connecticut. J. Consult. Clin. Psychol 66: 958–966.PubMedGoogle Scholar
  12. Ironson, G., Friedman, A., Klimas, N., Antoni, M., Fletcher, M. A., LaPerriere, A., Simoneau, J., and Schneiderman, N. (1994). Distress, denial, and low adherence to behavioral interventions predict faster disease progression in gay men infected with human immunodeficiency virus. Int. J. Behav. Med. 1: 90–105.Google Scholar
  13. Lennon, M. C., Martin, J. L., and Dean, L. (1990). The influence of social support on AIDS-related grief reaction among gay ment. Soc. Sci. Med. 31: 477–484.PubMedGoogle Scholar
  14. Leserman, J., Petitto, J. M., Golden, R. N., Gaynes, B. N., Gu, H., Perkins, D. O., Silva, S. G., Folds, J. D., and Evans, D. L. (2000). The impact of stressful life events, depression, social support, coping and cortisol on progression to AIDS. Am. J. Psychiatry 157: 1221–1228.PubMedGoogle Scholar
  15. Martin, J. L. (1988). Psychological consequences of AIDS-related bereavement among gay men. J. Consult. Clin. Psychol. 56: 856–862.PubMedGoogle Scholar
  16. Martin, J. L., and Dean, L. (1993). Effects of AIDS-related bereavement and HIV-related illness on psychological distress among gay men: A 7–year longitudinal study, 1985–1991. J. Consult. Clin. Psychol. 61: 94–103.PubMedGoogle Scholar
  17. Namir, S., Wolcott, D. L., Fawzy, F. I., and Alumbaugh, M. J. (1987). Coping with AIDS: Psychological and health implications. J. Appl. Soc. Psychol. 17: 309–328.Google Scholar
  18. Neugebauer, R., Rabkin, J., Williams, J., Remien, R., Goets, R., and Gorman, J. (1992). Bereavement reactions among homosexual men experiencing multiple losses in the AIDS epidemic. Am. J. Psychiatry 149: 1374–1379.PubMedGoogle Scholar
  19. Pakenham, K., Dadds, M. R., and Terry, D. J. (1994). Relationships between adjustment to HIV and both social support and coping. J. Consult. Clin. Psychol. 62: 1194–1203.PubMedGoogle Scholar
  20. Palella, F. J., Delaney, K. M., Moorman, A. E., Loveless, M. O., Fuhrer, J., Sutten, G. A., Aschmen, O. J., Holmbarg, S. O., The HIV Outpatient Study Investigators. (1998). Declining morbidity and mortality among patients with advanced human immunodeficiency virus infection. N. Engl. J. Med. 338: 853–860.PubMedGoogle Scholar
  21. Perry, S., Fishman, B., Jacobsberg, L., and Frances, A. (1992). Relationships over 1 year between lymphocyte subsets and psychosocial variables among adules with infection by human immunodeficiency virus. Arch. Gen. Psychiatry 49: 384–396.PubMedGoogle Scholar
  22. Rosengard, C., and Folkman, S. (1997). Suicidal ideation, bereavement, HIV serostatus and psychosocial variables in partners of men with AIDS. AIDS Care. 9: 373–384.PubMedGoogle Scholar
  23. Sikkema, K. J., Hansen, N. B., Kochman, A, Tate, D. C., and DiFranceisco, W. (July, 2002). (manuscript submitted for publication). Outcomes from a randomized controlled trial of a group intervention for HIV positive men and women coping with AIDS-related loss and bereavement.Google Scholar
  24. Sikkema, K. J., Hansen, N. B., Kochman, A., Tate, D. C., DiFranceisco, W., and Lee, R. S. (July, 2002). Coping with HIV and AIDS-related bereavement among HIV positive men and women: Outcomes from a group intervention trial. Paper presented at the Fourteenth International AIOS Conference, Barcelona, Spain.Google Scholar
  25. Sikkema, K. J., Kalichman, S. C., Hoffmann, R., Koob, J. J., Kelly, J. A., and Heckman, T. G. (2000). Coping strategies and emotional well-being among HIV-infected men and women experiencing AIDS-related bereavement. AIDS Care 12: 613–624.PubMedGoogle Scholar
  26. Sikkema, K. J., Kalichman, S. C., Kelly, J. A., and Koob, J. J. (1995). Group intervention to improve coping with AIDS-related bereavement: Model development and an illustrative clinical example. AIDS Care 7: 463–475.PubMedGoogle Scholar
  27. Sikkema, K. J., Koob, J. J., and Heckman, T. G. (April, 1997). Prevalence and predictors of AIDS-related bereavement among HIV-infected men and women. Paper presented at the Eighteenth Annual Meeting of the Society of Behavioral Medicine, San Francisco, CA.Google Scholar
  28. Simoni, J. M., and Ng, M. T. (2000). Trauma, coping and depression among women with HIV/AIDS in New York City. AIDS Care 12: 567–580.PubMedGoogle Scholar
  29. UNAIDS (2001). AIDS Epidemic Update: December 2001, World Health Organization, Geneva.Google Scholar
  30. Wainberg, M., and Friedland, G. (1998). Public health implications of antiretroviral therapy and HIV drug resistance. JAMA. 279: 1977–1983.PubMedGoogle Scholar
  31. Williams, J. B. W. (1988). Structured Interview Guide for the Hamilton Anxiety and Drepression Rating Scales (SIGH-AD). New York State Psychiatric Institute, New York.Google Scholar

Copyright information

© Plenum Publishing Corporation 2003

Authors and Affiliations

  • Kathleen J. Sikkema
    • 1
    • 2
    Email author
  • Arlene Kochman
    • 1
  • Wayne DiFranceisco
    • 2
  • Jeffrey A. Kelly
    • 2
  • Raymond G. Hoffmann
    • 2
  1. 1.Department of PsychiatryYale School of MedicineNew Haven
  2. 2.Department of Psychiatry and Behavioral MedicineMedical College of WisconsinMilwaukee

Personalised recommendations