Academic journal article Research and Theory for Nursing Practice

Bodies in Mutation: Understanding Lipodystrophy among Women Living with HIV/AIDS

Academic journal article Research and Theory for Nursing Practice

Bodies in Mutation: Understanding Lipodystrophy among Women Living with HIV/AIDS

Article excerpt

Over the past decade, the lipodystrophy syndrome has become one of the biggest challenges in the field dof HIV/AIDS. However, few qualitative studies have examined how lipodystrophy affects the lives of people living with HIV/AIDS by reconfiguring their bodies in unexpected ways. The main objective of this qualitative study was to explore and describe the transformation process that women experience following the onset of lipodystrophy. The data was collected using semistructured interviews and was then analyzed following the principles of grounded theory. The purpose of this article is to synthesize our research findings with a particular emphasis on the basis social process (BSP) that emerged during the data analysis, namely, the bodily transformation process. Our objective is to highlight the experiences shared by women who go through this bodily transformation process and the challenges they face as they move progressively from one bodily state to another. Following the presentation of the bodily transformation process, we will discuss the implications of our findings for the advancement of nursing knowledge as well as the development of theories specific to the situations of people who suffer from chronic conditions and undergo a physical transformation as a result of medical treatment. Lastly, we will address the implications of our findings for nursing research and nursing practice.

Keywords: AIDS; antiretroviral therapy; body; lipodystrophy; HIV; women

(ProQuest: ... denotes formulae omitted.)

Each of the medications that are currently used to stop the progression of HIV infection causes numerous adverse effects and complications that can negatively affect the quality of life of people living with HIV/AIDS. The lipodystrophy syndrome is among the most troubling adverse effects of highly active antiretroviral therapy (HAART) and it remains one of the biggest challenges in the field of HIV/AIDS. The lipodystrophy syndrome was first described by Carr et al. (1998) 2 years after the introduction of HAART, when the findings of a cross- sectional study indicated that protease inhibitors were significantly associated with lower total body fat and higher lipid levels. It is now recognized that lipodystrophy is caused by an abnormal redistribution of adipose tissue in the body and that the physical changes associated with this condition are most likely irreversible. In general, the signs of lipodystrophy manifest themselves progressively throughout the body and include a vast range of physical changes, such as peripheral fat wasting with loss of subcutaneous tissue in the face, arms, legs, and buttocks. Moreover, fat accumulation in the abdomen, breasts enlargement, and circumferential expansion of the neck (particularly in the dorsocervical region) (Ministère de la Santé et des Services Sociaux, 2005). As suggested by Grinspoon and Carr (2005), physical changes related to the loss (lipoatrophy) and/or the accumulation (lipoaccumulation) of adipose tissue are well documented in people living with HIV/AIDS; although at present, it remains difficult to determine exactly how many of people suffer from lipodystrophy. In fact, the prevalence of lipodystrophy in people living with HIV/AIDS is estimated along a wide range of variability, from 11%-83% (Grinspoon & Carr, 2005).

According to Galli, Cozzi-Lepri, et al. (2002) from the LipoICoNa Study, women living with HIV/AIDS are particularly at risk for lipodystrophy. Based on their research findings, they consider that female sex is an important variable in the development of adipose tissue alterations (ATAs) and argue that women are faced with an increased risk of developing lipodystrophy once they start an antiretroviral regimen. The small body of research on this particular topic suggests that women are disproportionally affected by this condition because they are at higher risk than men for ATAs (relative hazard [RH] ...: 4.01, p < .001; Galli, Cozzi-Lepri, et al. …

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