To gain a more complete view of the impact of HIV/AIDS, it is important to understand the psychosocial and emotional consequences of diagnosis with a potentially fatal disease.

In the introduction to When Someone Close Has AIDS: Acquired Immunodeficiency Syndrome (1989), Lewis L. Judd, the director of the National Institute of Mental Health, writes about the meaning of the diagnosis of AIDS. It means not only a shortened life but also one that is ''marred by chronic fatigue, loss of appetite and weight, frequent hospitalizations, AIDS dementia, and debilitating bouts of illness from unusual infections.'' The person diagnosed with HIV/AIDS also feels anger, confusion, depression, isolation, and hopelessness, which can also affect those around him or her who are often unprepared for the suffering they witness.

Judd advises that people diagnosed with HIV/AIDS need support and reassurance from friends and relatives that they will not be abandoned or isolated. He also recommends that those around HIV/AIDS patients encourage them to pursue hobbies, work as long as they can, and engage in social activities. Judd warns that caring for someone with AIDS is physically and emotionally exhausting and calls for inner strength, as well as the caregivers' coming to terms with their own feelings about the illness.

In ''The Stigma of AIDS: Persons with AIDS and Social Distance'' (Deviant Behavior, vol. 16, no. 4, October-December 1995), a survey of how knowledge and mode of transmission affect opinions of people with AIDS, Jason J. Leiker, Diane E. Taub, and Julie Gast note that as HIV/AIDS knowledge increases, people tend to attach less stigma to the disease.

According to the survey, respondents attached the least stigma to those infected by blood transfusions. The greatest stigma was attached to exposures from male-to-male sexual behavior and intravenous drug use. Survey participants who considered themselves homophobic (having a fear of or aversion to homosexuality) attached more of a stigma to people with AIDS than those who did not feel they were homophobic. People who labeled themselves ''religious'' attached less stigma to those infected through blood transfusions.

More than two decades after the first diagnoses of AIDS and widespread public health and community education efforts to inform people about HIV infection and prevent the spread of HIV, ignorance and misunderstanding of HIV/AIDS persist. Health educators and HIV/AIDS activists stress the importance of intensified, ongoing education to destigmatize people affected by HIV/AIDS and prevent discrimination. Reducing the stigma associated with HIV/AIDS may also encourage individuals to get tested and, for those who are infected, begin treatment as soon as possible.

Because stigma, even among personnel who work with people with HIV/AIDS, persists, efforts to reduce it continue. In 2007 the HIV/AIDS Stigma Program, funded by the Health Resource and Services Administration's HIV/AIDS Bureau, offered training programs that explored the stigma associated with HIV/AIDS. The programs, which are made available to staff employed by Ryan White CARE Act (RWCA) funded agencies or organizations, focus on:

-           Defining stigma and stigma's origins in our society

-           The impact of stigma on an individual's decision-making process and how it deters him or her from seeking HIV testing and counseling services

-           How stigma affects access to care, and disclosure of HIV-positive status

Not unexpectedly, anger and depression are natural and common reactions to discovering that one has an HIV infection. Even though experts stress the importance of recognizing and expressing anger and depression, if these feelings become all consuming, they can prevent health and life-improving actions. Many people with HIV/AIDS admit that sharing feelings with friends and family members and participating in support groups ease anguish and help generate more positive attitudes and actions.

Many HIV/AIDS sufferers report that the most difficult thing they had to do after being diagnosed with HIV was to inform people in their present or recent past whom they might have exposed to the virus. If the patient is unable to do this, a physician or public health official can notify present or former sexual partners without revealing the infected person's name.

The earlier a person learns of his or her infection, the earlier he or she can begin medical treatment to suppress the virus's destructive growth, delay the onset of AIDS symptoms, and extend life. Along with antiretroviral drugs there are medications that fight the life-threatening opportunistic infections that eventually afflict most people who are HIV infected. Even though these drugs cannot cure HIV infection, they have been shown to keep HIV/AIDS patients healthy and symptom-free for increasingly longer periods.

Experts advise HIV-infected people to exercise and maintain a balanced diet with sufficient lean protein. Not only does exercise improve overall fitness and generate a sense of well-being but also it releases endorphins, which are natural substances produced by the brain that boost immunity, reduce stress, and elevate mood. People with HIV/AIDS are advised to avoid smoking, excessive alcohol consumption, and using illegal drugs, all of which can act to depress the immune system.

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