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Case Scenario:
Jesse is a 22-year-old man who tested positive for HIV two years ago. His suspicions are that he's been HIV positive since his adolescence. You are the peer worker assigned to help Jesse with adherence issues. You have been seeing him for the past nine months. During the sessions, he has shared his concerns about his increase in alcohol/drug use and depression. Over the past month, Jesse has frequently mentioned his fear of failing his HAART regimen.
The thought of having to switch medications because of failing his current regimen has caused Jesse to feel depressed; he has been on the current regimen for one year. The combination of fear of failing his HIV treatment in addition to disappointing his doctor has caused Jesse's depression to worsen. Over the past nine months, Jesse has also been concerned with his body image. Although he works out in the gym regularly with weights, he's never satisfied with his physique. He has noticed changes in body fat buildup throughout his body, loss of fat in the face area, and his limbs have thinned. Jesse has also expressed concern about the effects of long-term treatment. Jesse recently read an article in an HIV/AIDS magazine that heart disease is another side effect of long-term treatment.
Besides his cousin, Jesse does not have anyone else he can talk to about his HIV status. But he rarely shares with his cousin his sex life involving men he meets at parks or in clubs. He admits to his peer worker that he often finds extra pills in his bottles at the end of the month. Jesse feels healthy, but his doctor has told him that his CD4 count (T-cells) is dropping and his viral load is increasing.
Discussion Questions
How would you address Jesse's concerns and work with him on adherence issues?
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