Everything changed: spiritual transformation in people with HIV.
OBJECTIVE
Spiritual Transformation (ST) is accompanied by dramatic changes in spiritual beliefs along with major changes in behaviors, self-view, and attitudes. This study examined types of ST, as well as its antecedents and consequences in people with HIV.


METHODS
Qualitative content analysis was used to analyze interviews about ST in people's lives in two samples: people with chronic HIV-disease (chronic disease sample, n = 74) and people with HIV who identified themselves as spiritual (spiritual sample, n = 73).


RESULTS
ST occurred in 39% of the chronic disease and 75% of the spiritual sample. These STs were generally positive (95%) and enduring (M = 8.71 +/- 7.43 years). ST was most frequently associated with spiritual experience (in particular near-death experience), substance-use recovery, and HIV/AIDS-diagnosis. Main antecedents were substance-use disorder, education/upbringing, and desire to change. Further themes were depression/helplessness, confrontation with illness/death, social support, and lifestyle. The top six consequences include spiritual intensification, more spiritual practices, positive feelings toward self, recovery from substance-use, finding new meaning and purpose in life, and increased self-knowledge. In the spiritual sample, there was a common pattern of hitting rock bottom with drugs, having a spiritual experience (in particular a near-death experience), and joining a drug program.


CONCLUSIONS
Positive ST occurs in a sizable proportion of people with HIV. Importantly, ST often results in an enduring substance-use recovery, and an improved quality of life as indicated by enhanced gratitude, appreciation, joy, sense of peace, and reduced fear of death.
Kremer
Heidemarie
H
Department of Psychology, University of Miami, Coral Gables, Florida 33124, USA. HeidemarieKremer@yahoo.de
Ironson
Gail
G
D000223:Adaptation, Psychological; D000328:Adult; D016022:Case-Control Studies; D002908:Chronic Disease / Q000523:psychology; D005260:Female; D015658:HIV Infections / Q000523:psychology*; D006801:Humans; D007398:Interpersonal Relations; D008016:Life Change Events; D008297:Male; D036301:Qualitative Research; D011788:Quality of Life; D012649:Self Concept; D029181:Spirituality; D019966:Substance-Related Disorders / Q000534:rehabilitation