In this essay I will explain why the following issues are most important to consider and keep in mind when caring for a person identified as being HIV positive or having AIDS. The issues that I consider most important are how this illness impacts on the patient psychologically; how to prevent HIV transmission and the interventions that are effective; what treatment is available; and the issues surrounding medication adherence and its importance.
How this issue impacts on the patient psychologically
Depression and depressive disorders are a common issue for people who are HIV positive, 40% to 48% of people who are HIV positive suffer from depression (Buchanan 2002; Lichtenstein 2002). This issue is important to consider when caring for a patient who is HIV positive because they are twice as likely, compared to other people without HIV to have a major depressive disorder (Buchanan 2002). Clinical depression is also more likely to occur the longer the patient has been affected, in the later stages of the HIV disease (Buchanan 2002; Lichtenstein 2002). The possibility of a HIV positive person developing depression significantly increases 18 months prior to the onset of symptoms, and it can increase morbidity and mortality (Lichtenstein 2002).
Depression is a significant issue when caring for any patient as it has a considerable negative impact on quality of life, and a severely debilitating effect on functioning than most other medical conditions (Buchanan 2002). People with HIV who are also diagnosed with a mood disorder have poorer physical health, mental health and wellbeing compared with people with HIV and without mood disorders (Buchanan 2002). The risk factors for people with HIV developing depression include a lack of social support, bereavement and poor relationships with close friends and family (Buchanan 2002).
A study was carried out with nursing home residents who were HIV positive, it compared nursing home residents who are HIV positive with depression to nursing home residents who were HIV positive without depression (Buchanan 2002). Residents with HIV and depression were more likely to be female; experience reduced social interaction or withdrawal from activities of long standing interests; have unsettled relationships; experience conflict with staff, family or friends; have no contact with family or friends; experience delusions or hallucinations; have nutritional problems; experience pain; have unstable health problems or an acute episode of a long term health problem; take more medications; receive a range of treatments and procedures; be evaluated by a mental health specialist; receive group therapy; receive interventions for reorientation; participate in a behaviour symptom evaluation program; and have a range of other diseases and infections (Buchanan 2002).
When a person is first diagnosed as being HIV positive they are faced with a range of psychological issues in coming to terms with the illness. Being diagnosed with a stigmatised illness results in HIV positive people believing their identity is insignificant (Lichtenstein 2002). Accepting this change results in a loss of self-esteem and compensatory behaviour, for example passing as normal in an effort to avoid being stigmatised by others (Lichtenstein 2002). There are many gender differences that exist in relation to psychological issues. HIV positive women are more likely to suffer from depression because they were unaware of being at risk; less likely to be supported by family, partner and friends; more likely to become socially isolated; are caregivers for children or HIV positive partners; and are more stigmatised (Lichtenstein 2002). Women also find it more difficult to come to terms with the illness as they were infection by their male partner who they trusted and feel betrayed and victimised as women assumed their heterosexual status would protect them from risk of infection...