[Coping with HIV infection and motivation for therapy in multi-drug dependent patients]

The intrapsychological process of working through the five stages of death in terminally ill patients (according to Kübler-Ross) was documented by videotaping semistructured interviews. There were 67 i.v. drug-dependent polytoxic HIV-positive inpatients. An inquiry was also made into their social niveau, the course of their addiction, the patients' legal status, and their previous experience with long-term therapy. Prevalent forms of working through the five stages of death could be established with reasonable reliability, and their influence could be determined on how the patients actually made use of offers of long-term therapy. The most important finding was that HIV-positive i.v. drug-addicted polytoxic patients started with a similar ratio of 1:3 in drug-free long-term therapy compared to HIV-negative i.v. drug-addicted polytoxic inpatients (n = 71). In the group of HIV-positive i.v. drug-addicted inpatients their individual means of psychologically working through their illness, their legal status and their previous experience with drug-free long-term therapy seem to be relevant factors in positive therapy motivation. This should be kept in mind when methadone programs are discussed.