WEEK 4: HIV AND MENTAL HEALTH Flashcards
Describe HIV milestones
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
Outline Botswana’s top 10 causes of death
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
Describe HIV epidemiology in Botswana.
Vulnerable populations:
*Individuals with substance use disorders and mental illness
*Sexual, gender, racial, and ethnic minorities
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?
Botswana
Describe the impact of ARV
*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.
Describe THE DUAL EFFECTS OF HIV
Biological level
Psychosocial level
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
Describe the HIV life cycle.
1.Binding and fusion(attachment)
2. Reverse transcription (conversion and integration)
3.Transcription and translation (replication)
4.Assembly, budding and maturation.
Describe the Binding and fusion stage in life cycle of HIV
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.
Describe reverse transcription
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.
Describe transcription and translation in HIV life cycle.
The infected T Helper HIV proteins are used to produce more HIV particles inside the cell.
Describe Assembly, budding and maturation stage in HIV life cycle
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
At what CD4 count does HIV progresses to AIDS?
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.
State the effects of HIV on CNS
DIRECT EFFECT OF HIV
INDIRECT EFFECTS OF HIV
*Headache
*Aseptic meningitis
*HIV-associated dementia
*minor cognitive motor disorder
*vascular myelopathy
State the effects of HIV on CNS
INDIRECT EFFECTS OF HIV
State the psychological problems associated with HIV infection
*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
State the psychosocial challenges on TESTING HIV POSITIVE
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.)
Outline misconceptions or stereotypes about HIV/AIDS
Drug User?
Gay?
Multiple Partners?
Punishment from God?
Deserve to get this disease
Promiscuity?
Discuss STIGMA and DISCRIMINATION IN HIV/AIDS
“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.
Discuss the impact of HIV on an individual
*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
Describe the IMPACT OF HIV ON FAMILY
Guilt, sadness, Anger
Inability to accept status
Family routine affected
Describe Common Mental Health Issues for People Living with HIV/AIDS
*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
Describe the impact of depression in HIV AND AIDS
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
Link drug and substance abuse to HIV and AIDS
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
Describe the concerns for drug and alcohol abuse in people living with HIV and AIDS
Interactions with prescribed medications
Possible overdose
Addiction
Non-adherence to prescribed medication treatment
Housing and/or poverty issues
Missing health care appointments
Describe suicidal attempts/ suicide in relation to HIV and AIDS
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
