Recreation & AIDS: Reflections and Reaffirmation

Article excerpt

Nearly 20 years ago, the virus known as HIV (human immunodeficiency virus) was first recognized clinically. Since then, 16 million people have died--nearly 3 million in 1999 alone. Worldwide, 33.6 million people are infected with HIV (Sternberg, 1999).

HIV, the virus that causes AIDS, is a disease that attacks and ultimately cripples a person's immune system. The AIDS disease spectrum includes persons with clinical cases of AIDS, HIV-related illnesses, and persons who are infected with HIV but are asymptomatic. Individuals with HIV-related illnesses may experience minor symptoms such as enlarged lymph glands or may contract more serious illnesses that result in death.

In the past 20 years, the public's awareness of HIV/AIDS has increased, numerous prevention education programs have been implemented, and millions of research dollars have been committed. However, there remains a dearth of information related to the role of recreation/therapeutic recreation in AIDS services and treatment.

AIDS was initially thought to affect a relatively small group of individuals in the United States, primarily homosexual or bisexual men and intravenous drug users. Although these groups represent a large portion of the reported cases of AIDS in the United States, the AIDS virus does not discriminate--gays, drug users, minorities, men, women, and children can all be affected. Individuals who are sexually active and/or use intravenous drugs are at high risk; however, the AIDS epidemic is increasing most rapidly among poor minorities (Cunningham, Davidson, Nakazono, & Andersen, 1999), women, and children (Grossman, 1991a; Keller, 1992; Landry & Smith, 1998). People become infected due to high-risk behavior, not because of "group" membership. HIV/AIDS can strike individuals of varying ages, cultural or ethnic groups, and lifestyle preferences.

Over the past 15 years, the life expectancy of persons with HIV/AIDS has increased due to new medications (Landry & Smith, 1998); however, there is no immediate cure. Therefore, it is important to discover alternatives for giving meaning and purpose to persons affected by the virus. Individuals need activities that provide immediate gratification, as well as those that assist them in coping with the unique problems of the disease (e.g., stigma, public fear, the need for confidentiality, and personal or parental anxiety). They also need activities that promote individual well being, regardless of the level of functioning, and that maintain functional independence as the disease progresses.

AIDS is a family disease (Grossman, 1997; Grossman, 1992; Keller, 1992; Landry & Smith, 1998). All aspects of family life--social roles, economic functioning, familial relationships, parenting, and leisure are disrupted when a family member has HIV/AIDS. It is essential that recreation professionals understand the impact of HIV/AIDS on families so they can more effectively deliver recreation services to people living with HIV/AIDS and their spouses, partners, siblings, children, and parents.

AIDS clearly extends beyond the need for medical intervention. It also requires reducing the stressors associated with the complex social and psychological needs of those diagnosed. Psychological factors, such as guilt, hopelessness, helplessness, and loss of control, coupled with physical manifestations, such as weight loss, visible lesions, bladder and bowel incontinence, and coordination problems, limit and inhibit established recreation lifestyles. In addition, individuals with AIDS are often isolated from peers, family, and co-workers, which weakens one's sense of identity.

One third of the nation's HIV patients (83,000 people) have not received medical care because they could not afford it. Minorities, women, drug abusers, and people living in poverty are the least likely to seek medical attention because food and shelter take priority in their limited budgets (Landsberg, 1999). …