WEEK 4: HIV AND MENTAL HEALTH

Question 1

Describe HIV milestones

Answer 1

1.Early 1980s – first cases​

​2.Mid 1980s – HIV test available​

​3.Late 1980s to early 1990s – minimal benefit from antiretroviral therapy​

​Time from AIDS diagnosis to death = 2 years​

PCP prophylaxis reduces mortality in patients with HIV infection(Prophylaxis against carinii pneumonia (PCP)​

​4.Mid 1990s – Highly Active Antiretroviral Therapy (HAART)​

HIV/AIDS became a chronic illness

Question 2

Outline Botswana’s top 10 causes of death

Answer 2

1.HIV/AIDS​

2.lschemic heart disease​

3.Stroke​

4.Lower respiratory infections​

5.Diabetes​

6.Diarrheal diseases​

7.Tuberculosis​

8.Neonatal disorders​

9.Chronic obstructive pulmonary disease​

10.Alzheimer’s disease

Question 3

Describe HIV epidemiology in Botswana.

Answer 3

Vulnerable populations:​

*Individuals with substance use disorders and mental illness​

*Sexual, gender, racial, and ethnic minorities​

Question 4

It was the first country in the region to provide universal free antiretroviral treatment (ART) to people living with HIV, paving the way for many other countries in the region to follow.

Has demonstrated strong commitment in responding to its HIV epidemic and has become an exemplar within sub-Saharan Africa.

What country is this?

Answer 4

Botswana

Question 5

Describe the impact of ARV

Answer 5

*New infections have decreased significantly, from 18,000 in 2005, to 10,000 in 2010, and down to 8,500 in 2018. ​
*AIDS-related deaths have also dramatically decreased from a peak of 18,000 recorded in 2002 to 4,800 in 2018.​

Question 6

Describe THE DUAL EFFECTS OF HIV​
Biological level​
Psychosocial level

Answer 6

HIV/AIDS as an illness affects a person first at the biological level when the virus infects a person at the cellular level, enters various body systems including the immune system and compromises the immunity​

​Secondly the HIV/aids as an illness has major psychosocial effects on the HIV infected person, the family, the community and the society at large​

​

Question 7

Describe the HIV life cycle.

Answer 7

1.Binding and fusion(attachment)​

​2. Reverse transcription (conversion and integration)​

3.Transcription and translation (replication)​

4.Assembly, budding and maturation​.

Question 8

Describe the Binding and fusion stage in life cycle of HIV

Answer 8

The CD 4(T-helper cell) cells are vital cells of the immune system, which keep us healthy by fighting off infections and diseases​

​The HIV infects the white blood cells in the T-helper cell​

But The HIV cannot reproduce on its own.​

Instead, the virus attaches itself to a T- helper cell and fuses /joins with it and releases its genetic material into the cell.​

Question 9

Describe reverse transcription

Answer 9

Once inside the T-helper cell, the HIV converts its genetic material into HIV DNA​

The new HIV DNA then enters the nucleus of the host cell and takes control of it.​

Question 10

Describe transcription and translation in HIV life cycle.

Answer 10

The infected T Helper HIV proteins are used to produce more HIV particles inside the cell.​

Question 11

Describe Assembly, budding and maturation stage in HIV life cycle

Answer 11

The new HIV is put together and then released from the T-Helper cell into the blood stream to infect other cells​

And then the above process begins again

Question 12

At what CD4 count does HIV progresses to AIDS?

Answer 12

When the HIV has destroyed a certain number of CD4 cells, and the CD 4 count drops below 200 then the person will have progressed to AIDS​.

Question 13

State the effects of HIV on CNS
DIRECT EFFECT OF HIV​
INDIRECT EFFECTS OF HIV​

Answer 13

*Headache
*Aseptic meningitis
*HIV-associated dementia
*minor cognitive motor disorder
*vascular myelopathy

Question 14

State the effects of HIV on CNS
INDIRECT EFFECTS OF HIV

Question 15

State the psychological problems associated with HIV infection

Answer 15

*Psychosocial development
is how a person’s mind, emotions, and maturity level develop throughout the course of their lifetime.

Different people will develop psychosocially at different speeds depending on biological processes and environmental interactions.

 People living with HIV have very specific psycho-social issues they deal with.

It is important to understand that the mind and emotions do have an impact on the immune system and their quality of life.

*Most patients with progressive illness confront a range of psychological challenges:

-The prospect of REAL and ANTICIPATED losses

-Worsening Quality of life

*HIV infection and / or AIDS brings ADDITIONAL challenges due to rapidly changing treatment developments and outlook( = HIV highly infectious, potentially fatal and highly stigmatized)

-Fear of physical Decline and DEATH

-Coping with UNCERTANTY

Question 16

State the psychosocial challenges on TESTING HIV POSITIVE

Answer 16

Acute Distress
Shock and disbelief
Fear and Panic
Experience of GUILT(I should have known better)
Anger
Anxiety about goals and priorities
Despair
Numbness/ helplessness,
high risk behavior (suicidal attempts, substance use etc.)

Question 17

Outline misconceptions or stereotypes about HIV/AIDS

Answer 17

 Drug User?​

 Gay?​

 Multiple Partners?​

 Punishment from God?​

 Deserve to get this disease​

 Promiscuity?​

Question 18

Discuss STIGMA and DISCRIMINATION IN HIV/AIDS

Answer 18

“Stigma is the co-occurrence of labeling, stereotyping, separation, status loss, and discrimination” in a situation in which power is exercised

*Stigma can prevent people from:​

-talking about and acknowledging HIV as a major cause of illness & death. ​

*Stigma also can prevent HIV-infected people from:​

-seeking counseling​

-obtaining medical and psychological care a​

-and taking preventative measures to avoid infecting others.

Question 19

Discuss the impact of HIV on an individual

Answer 19

*CONFIDENTIALITY AND DISCLOSURE​: People with HIV/AIDS worry about confidentiality. ​
Deciding who and when to tell is not easy. ​

*SELF ESTEEM and SELF CRITICISM​:

*SOCIAL ISOLATION​:
People with HIV/AIDS worry about telling their families & other relationships about their status​

-Some family and friends choose to withdraw because of:​
- Fear of death​
-Helplessness ​
-Fear of “catching” HIV/AIDS ​
-Shame and pressure from the stigma

*INTIMACY AND SEXUALITY​

Living with HIV/AIDS can be a barrier to having intimate or sexual relationships.​

​ Self isolation can increase a sense of depression and complicate intimacy and sexuality​

*SPIRITUALITY AND RELIGION

-Spirituality & religious beliefs, may take on increasing importance to people living with HIV/AIDS. ​
- Supporting the spiritual needs of people living with HIV/AIDS and their families is a​
- critical component of compassionate care. ​
-It can engender hope​

Question 20

Describe the IMPACT OF HIV ON FAMILY​

Answer 20

Guilt, sadness, Anger​

Inability to accept status​

Family routine affected​

Question 21

Describe Common Mental Health Issues for People Living with HIV/AIDS

Answer 21

*DEPRESSION and HIV/AIDS​

It is more intense and lasts longer than it should(at least 2 weeks) plus feeling low in energy/fatigue and loss of interest in activities one used to enjoy doing​

​- Depression can be linked to:​

-Events in one’s daily life​

-Chemical changes in the brain​

-Side effects of required medications​

-Several physical disorders​

Question 22

Describe the impact of depression in HIV AND AIDS

Answer 22

Non-adherence to Medications​

Non-attendance at medical appointments​

Non-engagement with providers​

Poor care for co-morbid medical conditions​

Increased risk of contracting and transmitting HIV​

Question 23

Link drug and substance abuse to HIV and AIDS

Answer 23

Some people living with HIV/AIDS use substances for a variety of reasons:​

​- Help to control or counteract side effects of medications​

-To socialize​

-As part of a process of harm reduction ​

-To escape ​

-To self medicate for mental health problems they’re dealing with

Question 24

Describe the concerns for drug and alcohol abuse in people living with HIV and AIDS

Answer 24

Interactions with prescribed medications​

Possible overdose ​

Addiction​

Non-adherence to prescribed medication treatment​

Housing and/or poverty issues​

Missing health care appointments​

Question 25

Describe suicidal attempts/ suicide in relation to HIV and AIDS

Answer 25

Many events can trigger suicidal thoughts among people living with HIV/AIDS. ​

They can include:​

Learning about their positive HIV status; receiving an AIDS diagnosis.​

Fear of disclosing to family & friends ​