Factitious HIV Syndrome in Young Women
Factitious HIV Syndrome in Young Women
Factitious HIV infection has been observed at our center in women presenting with a false history of HIV/AIDS. In a 2-year period, 4 women presented for HIV-related care, indicating they were HIV-seropositive, while repeated serologic testing revealed no evidence of HIV infection. In all cases, the women were either quite angry or appeared surprised when told that they did not have HIV infection. A commondenominator in all 4 women was a history of prolonged sexual, physical, or emotional abuse. Three of the 4 had been to other physicians, changing doctors as soon as the absence of HIV infection was established. Appropriate psychiatric support is an important aspect in care of these women, although it may not be accepted. All presentations of HIV infection should be confirmed either by identifying hard-copy data of HIV test results or by retesting all patients before evaluation and treatment of presumed HIV-related illnesses.
One million Americans are thought to be HIV-seropositive, and fear of HIV infection likely affects millions more. However, HIV seronegativity can be confirmed with reliable testing. Since the onset of the AIDS epidemic, several cases of factitious AIDS have been reported. In a few reported cases, a diagnosis of HIV or AIDS has been found to be purely a delusion. In others, overt secondary gain is a motivating factor. Retrospective analyses of clinic visits at several centers have shown that if the initial diagnosis of HIV infection is not clearly documented, HIV-negative patients may receive inappropriate therapy for months, as well as other services, including social or nursing support, prescription drugs, and controlled substances.
Here, we describe 4 women with "factitious HIV infection" who presented to the Miriam Hospital immunology center for care of HIV disease -- each with a background of sexual and/or physical abuse.
Factitious HIV infection has been observed at our center in women presenting with a false history of HIV/AIDS. In a 2-year period, 4 women presented for HIV-related care, indicating they were HIV-seropositive, while repeated serologic testing revealed no evidence of HIV infection. In all cases, the women were either quite angry or appeared surprised when told that they did not have HIV infection. A commondenominator in all 4 women was a history of prolonged sexual, physical, or emotional abuse. Three of the 4 had been to other physicians, changing doctors as soon as the absence of HIV infection was established. Appropriate psychiatric support is an important aspect in care of these women, although it may not be accepted. All presentations of HIV infection should be confirmed either by identifying hard-copy data of HIV test results or by retesting all patients before evaluation and treatment of presumed HIV-related illnesses.
One million Americans are thought to be HIV-seropositive, and fear of HIV infection likely affects millions more. However, HIV seronegativity can be confirmed with reliable testing. Since the onset of the AIDS epidemic, several cases of factitious AIDS have been reported. In a few reported cases, a diagnosis of HIV or AIDS has been found to be purely a delusion. In others, overt secondary gain is a motivating factor. Retrospective analyses of clinic visits at several centers have shown that if the initial diagnosis of HIV infection is not clearly documented, HIV-negative patients may receive inappropriate therapy for months, as well as other services, including social or nursing support, prescription drugs, and controlled substances.
Here, we describe 4 women with "factitious HIV infection" who presented to the Miriam Hospital immunology center for care of HIV disease -- each with a background of sexual and/or physical abuse.