P0353 - Social and psychological aspects of haemophilia - Case report

Abstract

34-year old patient with haemophilia A, HIV and Hepatitis C (HCV) infection was sent for psychiatric evaluation before starting the treatment of HCV with interferon. He was infected with HIV through plasma concentrate in the age of 12 years. In that time, he has been told to have an HIV infection, without any concrete psychological support. He started the treatment of HIV infection, which was succesful, with seroconversion several years ago. But the psychological problems, such as feelings of stigma, social isolation and uncertainty remained.

At first interview he expressed anger on the hole medical team, including psychitrist. He denied any psychological problems and was trying to devaluate the conversation. Later on, during the once weekly psychotherapy sessions several important issues arose.

1. - For long time he was stigmatised and discriminated inside his family due to HIV infection. His feeling towards the members of his family and stigma due to HIV infection have been adressed during the psychotherapy. Later on in the course of psychotherapy, it became clear that he is stigmatised due to haemophilia and HCV infection, too.

2. - He holds the destructive pattern in intimate relationships. He ended several relationships because of the fear to tell his partner about the HIV and HCV infection.

3. - As defence mechanisms he has been using projection, denial and racionalizations.

4. - He started to talk about his past, often traumatic memories and feelings around haemophilia, HIV infection in terms of manageble disease.