Further evidence of the difference between HIV/AIDS and cancer can be found in the type of roles that are commonly attributed or available to patients with each diagnosis. Consider cancer survivor, an archetype that entails enthusiastic social approval and support. Cancer survivors are often presented in the media as heroes, who through their positive outlook and high capacity for coping become role models for the rest of society. There’s no equivalent heroic mantle bestowed as frequently or celebrated as often or widely in the media for people coping with HIV/AIDS. They continue to be labeled simply as HIV positive.5
Even for people who today appear to enjoy every benefit of social validation, a cancer diagnosis can activate unresolved trauma surrounding a previous HIV diagnosis. The fear, shame and sense of social rejection that may have been the context of their HIV diagnosis may affect how they experience and respond to their current cancer diagnosis, which can in turn limit the person’s access to necessary social and emotional support.
WHAT YOU SHOULD EXPECT
What does this mean in the hospital or treatment room? As with any other patient, care should be taken to examine any assumptions you may have made about the patient or their experience. Keep in mind that the patient is likely to suffer increased stress due to perceived and actual social isolation and lack of support. In addition, the patient may have a history of coping with a terrifying disease even before their cancer diagnosis, and that the cancer diagnosis may reactivate traumatic memories and unresolved feelings regarding their original HIV diagnosis, even if that was decades prior.
The bottom line is that people with a dual HIV/AIDS and cancer diagnosis are more likely to suffer the effects of social rejection and internalized shame that result in diminished available social, emotional, medical, and financial support, than patients with simply a cancer diagnosis.
1. Highleyman L. People with HIV are at higher risk of several types of cancer, large study finds. Nam aidsmap Web site. http://www.aidsmap.com/People-with-HIV-are-at-higher-risk-of-several-types-of-cancer-large-study-finds/page/3004717/. Published October 7, 2015. Accessed February 5, 2016.
2. National Cancer Institute
3. Barbaro G, Barbarini G. HIV infection and cancer in the era of highly active antiretroviral therapy (Review). Oncol Rep. 2007;17(5):1121-1126.
4. Schwarzer R, Weiner B. Stigma controllability and coping as predictors of emotions and social support. J Soc Pers Relat. 1991;8(1):133-140.
5. Fife BL, Wright ER. The dimensionality of stigma: a comparison of its impact on the self of persons with HIV/AIDS and cancer. J Health Soc Behav. 2000;41(1):50-67.