The Cortez Family
Paula is a 43
-
year
-
old HIV
-
positive Latina woman originally from Colombia. She is bilingual, fluent in both
Spanish and English. Paula lives alone in an apartment in Queens, NY. She is divorced and has one son,
Miguel, who is 20 years old. Paula maintains a relationship with her son and her ex
-
husband, David (46).
Paula raised Miguel until he was 8 years old, at
which time she was forced to relinquish custody due to
her medical condition. Paula is severely socially isolated as she has limited contact with her family in
Colombia and lacks a peer network of any kind in her neighborhood. Paula identifies as Catholic
, but she
does not consider religion to be a big part of her life. Paula came from a moderately well
-
to
-
do family.
She reports suffering physical and emotional abuse at the hands of both her parents, who are alive and
reside in Colombia with Paula’s two si
blings. Paula completed high school in Colombia, but ran away
when she was 17 years old because she could no longer tolerate the abuse at home. Paula became an
intravenous drug user (IVDU), particularly of cocaine and heroin. David, who was originally from
New
York City, was one of Paula’s “drug buddies.” The two eloped, and Paula followed David to the United
States. Paula continued to use drugs in the United States for several years; however, she stopped when
she got pregnant with Miguel. David continued t
o use drugs, which led to the failure of their marriage.
Once she stopped using drugs, Paula attended the Fashion Institute of Technology (FIT) in New York City.
Upon completing her BA, Paula worked for a clothing designer, but realized her true passion wa
s
painting. She has a collection of more than 100 drawings and paintings, many of which track the course
of her personal and emotional journey. Paula held a full
-
time job for a number of years before her
health prevented her from working. She is now unempl
oyed and receives Supplemental Security
Insurance (SSI) and Medicaid. Paula was diagnosed with bipolar disorder. She experiences rapid cycles of
mania and depression when not properly medicated, and she also has a tendency toward paranoia.
Paula has a hist
ory of not complying with her psychiatric medication treatment because she does not
like the way it makes her feel. She often discontinues it without telling her psychiatrist. Paula has had
multiple psychiatric hospitalizations but has remained out of the
hospital for at least five years. Paula
accepts her bipolar diagnosis, but demonstrates limited insight into the relationship between her
symptoms and her medication. Paula was diagnosed HIV positive in 1987. Paula acquired AIDS several
years later when sh
e was diagnosed with a severe brain infection and a T
-
cell count less than 200.
Paula’s brain infection left her completely paralyzed on the right side. She lost function of her right arm
and hand, as well as the ability to walk. After a long stay in an ac
ute care hospital in New York City, Paula
was transferred to a skilled nursing facility (SNF) where she thought she would die. It is at this time that
Paula gave up custody of her son. However, Paula’s condition improved gradually. After being in the SNF
f
or more than a year, Paula regained the ability to walk, although she does so with a severe limp. She
also regained some function in her right arm. Her right hand (her dominant hand) remains
semiparalyzed and limp. Over the course of several years, Paula t
aught herself to paint with her left
hand and was able to return to her beloved art. In 1996, when highly active antiretroviral therapy
(HAART) became available, Paula began treatment. She responded well to HAART and her HIV/AIDS was
well controlled. In ad
dition to her HIV/AIDS disease, Paula is diagnosed with hepatitis C (Hep C). While
this condition was controlled, it has reached a point where Paula’s doctor is recommending she begin
treatment. Paula also has significant circulatory problems, which cause
her severe pain in her lower
extremities. She uses prescribed narcotic pain medication to control her symptoms. Paula’s circulatory
problems have also led to chronic ulcers on her feet that will not heal. Treatment for her foot ulcers
demands frequent visi
ts to a wound care clinic. Paula’s pain paired with the foot ulcers make it difficult
for her to ambulate and leave her home. As with her psychiatric medication, Paula has a tendency not to
The Cortez Family
Paula is a 43-year-old HIV-positive Latina woman originally from Colombia. She is bilingual, fluent in both
Spanish and English. Paula lives alone in an apartment in Queens, NY. She is divorced and has one son,
Miguel, who is 20 years old. Paula maintains a relationship with her son and her ex-husband, David (46).
Paula raised Miguel until he was 8 years old, at which time she was forced to relinquish custody due to
her medical condition. Paula is severely socially isolated as she has limited contact with her family in
Colombia and lacks a peer network of any kind in her neighborhood. Paula identifies as Catholic, but she
does not consider religion to be a big part of her life. Paula came from a moderately well-to-do family.
She reports suffering physical and emotional abuse at the hands of both her parents, who are alive and
reside in Colombia with Paula’s two siblings. Paula completed high school in Colombia, but ran away
when she was 17 years old because she could no longer tolerate the abuse at home. Paula became an
intravenous drug user (IVDU), particularly of cocaine and heroin. David, who was originally from New
York City, was one of Paula’s “drug buddies.” The two eloped, and Paula followed David to the United
States. Paula continued to use drugs in the United States for several years; however, she stopped when
she got pregnant with Miguel. David continued to use drugs, which led to the failure of their marriage.
Once she stopped using drugs, Paula attended the Fashion Institute of Technology (FIT) in New York City.
Upon completing her BA, Paula worked for a clothing designer, but realized her true passion was
painting. She has a collection of more than 100 drawings and paintings, many of which track the course
of her personal and emotional journey. Paula held a full-time job for a number of years before her
health prevented her from working. She is now unemployed and receives Supplemental Security
Insurance (SSI) and Medicaid. Paula was diagnosed with bipolar disorder. She experiences rapid cycles of
mania and depression when not properly medicated, and she also has a tendency toward paranoia.
Paula has a history of not complying with her psychiatric medication treatment because she does not
like the way it makes her feel. She often discontinues it without telling her psychiatrist. Paula has had
multiple psychiatric hospitalizations but has remained out of the hospital for at least five years. Paula
accepts her bipolar diagnosis, but demonstrates limited insight into the relationship between her
symptoms and her medication. Paula was diagnosed HIV positive in 1987. Paula acquired AIDS several
years later when she was diagnosed with a severe brain infection and a T-cell count less than 200.
Paula’s brain infection left her completely paralyzed on the right side. She lost function of her right arm
and hand, as well as the ability to walk. After a long stay in an acute care hospital in New York City, Paula
was transferred to a skilled nursing facility (SNF) where she thought she would die. It is at this time that
Paula gave up custody of her son. However, Paula’s condition improved gradually. After being in the SNF
for more than a year, Paula regained the ability to walk, although she does so with a severe limp. She
also regained some function in her right arm. Her right hand (her dominant hand) remains
semiparalyzed and limp. Over the course of several years, Paula taught herself to paint with her left
hand and was able to return to her beloved art. In 1996, when highly active antiretroviral therapy
(HAART) became available, Paula began treatment. She responded well to HAART and her HIV/AIDS was
well controlled. In addition to her HIV/AIDS disease, Paula is diagnosed with hepatitis C (Hep C). While
this condition was controlled, it has reached a point where Paula’s doctor is recommending she begin
treatment. Paula also has significant circulatory problems, which cause her severe pain in her lower
extremities. She uses prescribed narcotic pain medication to control her symptoms. Paula’s circulatory
problems have also led to chronic ulcers on her feet that will not heal. Treatment for her foot ulcers
demands frequent visits to a wound care clinic. Paula’s pain paired with the foot ulcers make it difficult
for her to ambulate and leave her home. As with her psychiatric medication, Paula has a tendency not to
iusinppsw9
CortezFamily.docx
0
