Currently, with the increase in life expectancy of people living with HIV (PLHIV), it is essential to analyze the biopsychosocial aspects involved in satisfaction with quality of life and its multidimensionality, because although HAART produces hope for the control of HIV, can have important emotional consequences. Thus, the aim of the present study was to evaluate the effects of lipodystrophy (LDS) on self-esteem and body image of PLHIV in Brazil. It is a psychoanalytic method by semi-structured interview, a body image scale and two drawings that represent the patients’ body image before and after. The diagnosis of LDS was by self-report. Sixteen patients 8 (eight men and 8 women), with a mean age of 43 years, were invited to the HIV-Out ADEE 3002 outpatient clinic of the Dermatology Clinic of the Central Institute of a University Hospital in São Paulo. It was noted that 50% of patients reported physical problems and 25% consequences in the family and social sphere. There were increased bodily changes, family problems and social prejudices after HAART and the self-esteem of 88% of patients were shown to be “little adjusted” to their condition. For 63%, physical appearance was a concern and 87% of them reported body dissatisfaction. Patients also reported impact on their sexuality (75% felt less attractive and 88% with reduced libido after starting LDS). The interviews, drawings and body image scale showed important changes in the lives of patients with lipodystrophy, where negative changes in appearance and effects on self-image were observed. This diagnosis seems to influence other aspects of social life, which can lead to prejudice in relation to illness and, therefore, isolation.
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