Maria Valdez is a 45-year-old who has learned that she is HIV-positive. She is asymptomatic, has a normal physical examination, and all routine laboratory tests are normal. Her CD4 cell count is 325 cells per cubic millimetre, and her plasma HIV-1 RNA level is 60,000 copies per millilitre (both confirmed on repeated testing). She and her ex-husband have been divorced for years but maintain good relationships. Maria has a supportive extended family, church community, and neighbours. She has a full-time job and several committed friends that she grew up with. Maria has been seeing her current boyfriend for 2 years; however, she was not aware that he was engaging in unprotected sex outside of their relationship. Maria is distraught. â€œHow can I live with myself? I am a disgrace to my children and family.â€ Within several weeks, Maria returns to work and starts to assume more daily household responsibilities. When she is encouraged to talk about her feelings and see a therapist, Maria states, â€œI will be able to do everything I did before. I feel healthy.â€ The nurse has several concerns, including Mariaâ€™s focus on self-care, acceptance and understanding of her HIV-positive status, and her willingness to disclose her status to sexual/intimate partners.
a. How would you evaluate Mariaâ€™s social support system?
b. What other information would you like to know about her situation that might help your assessment?
c. What do you need to know about her cultural beliefs about illness?
d. What recommendations or referrals could you make for her? How would you approach these recommendations?
e. From what you know about Maria, identify the strengths she has that you would support and encourage.