Integrating Mental Health Services with HIV Primary Care

A woman stands at her son's grave in a newly opened section of a large cemetery in the Bronx. She and her therapist, psychologist Kathleen Romano, pluck dead leaves from the geranium planted there, and talk about the son as a child, as a man, and now as a spirit hovering nearby, at peace and released from the pain of drug addiction and AIDS. In an HIV-positive psychotherapy group at a methadone program, the men segue from English to Spanish and back again. Fred Millan, a Puerto Rican clinical psychologist who grew up in New York, conducts the group with the view that membership in an oppressed group is a significant dynamic. A hospitalized woman, with a long history of substance use, believed she would always be utterly alone. Now, members of her psychotherapy group for HIV-positive women congregate at her bedside, and among them is social worker Noel Elia, one of the group's facilitators.