A Biopsychosocial Approach to Treatment

2010 ◽  
Author(s):  
Mary Ann Cohen ◽  
Harold W. Goforth
Keyword(s):  
Hiv Transmission ◽  
Age Of Onset ◽  
Systems Of Care ◽  
Early Recognition ◽  
Immune Deficiency Syndrome ◽  
Deficiency Syndrome ◽  
Hiv And Aids ◽  
Medical Systems ◽  
Aids Epidemic ◽  
Human Contact

The care of persons with HIV and AIDS presents clinicians, caregivers, families, and loved ones with special biopsychosocial challenges posed by the infectious nature of HIV, the specific modes of HIV transmission, the particular way HIV affects the brain, the age of onset, and the complex stigma of HIV. These challenges differentiate AIDS from other severe and complex illnesses, causes, have significant clinical and public health implications, and necessitate early recognition and treatment. The multifactorial nature of these challenges is summarized in Table 11.1, and some unique aspects of AIDS are briefly summarized in Table 11.2. AIDS psychiatrists, psychosomatic medicine psychiatrists, physicians trained in both medicine and psychiatry, and other mental health clinicians can play a vital role the care of persons with HIV and AIDS, in the prevention of HIV transmission, and in training of other clinicians to alleviate distress, reduce ongoing high-risk behavior and nonadherence, provide support for patients and families, and improve patients’ quality of life. In this chapter, we will review the biopsychosocial aspects of AIDS and suggest strategies to address the unique challenges of this devastating and complex illness. Although the AIDS epidemic was first described in the medical literature in 1981, it was not until 1983 that the first articles were published about the psychosocial or psychiatric aspects of AIDS. The first article was not written by a psychiatrist. This article, written by Holtz and colleagues (1983), was essentially a plea for attention to the psychosocial aspects of AIDS. They stated that “noticeably absent in the flurry of publications about the current epidemic of acquired immune deficiency syndrome (AIDS) is reference to the psychosocial impact of this devastating new syndrome.” The authors deplored ostracism of persons with AIDS by both their families and their medical systems of care. These authors were the first to describe the profound withdrawal from human contact as the “sheet sign” observed when a person with AIDS drew a bed sheet over his or her face and head, essentially withdrawing and hiding from visitors.

scholarly journals Penerapan Arsitektur Perilaku Pada Perancangan Panti Rehabilitasi Untuk Orang Dengan HIV/AIDS Di Sleman

Vitruvian ◽  
2019 ◽  
Vol 8 (3) ◽  
pp. 100
Author(s):  
Agus Cahyadi ◽  
Muhammad Arief Kurniawan
Keyword(s):  
Immune Deficiency ◽  
Hiv Transmission ◽  
Immune Deficiency Syndrome ◽  
Deficiency Syndrome ◽  
Hiv And Aids ◽  
Rehabilitation Center ◽  
Global Issues ◽  
Observation Process ◽  
Initial Survey ◽  
Hiv Aids

ABSTRAK HIV dan AIDS (Acquire Immune Deficiency Syndrome) merupakan masalah global. Kurangnya pengetahuan akan cara penularan virus HIV dan pengobatan terhadap ODHA di Indonesia, membuat semakin meningkatnya kasus HIV dan AIDS setiap tahunnya dan muncul berbagai stigma negatif dari masyarakat terhadap ODHA. Dengan adanya stigma negatif dari masyarakat lain terhadap penyakitnya membuat ODHA memiliki rasa takut, tidak percaya diri, marah, malu dan kecewa pada dirinya sendiri. Metode perancangan yang digunakan adalah metode pendekatan arsitektur perilaku. Beberapa data awal yang telah ditemukan pada survei awal, dikembangkan dalam survei lanjutan. Data-data tersebut kemudian diperdalam dan dikembangkan melalui serangkaian survei yang dilakukan berulang kali. Proses analisis merupakan bagian yang menyatu dengan proses observasi data. Dari proses ini kemudian dibangun konstruksi teori dari lapangan. Untuk memenuhi semua kebutuhan dalam proses rehabilitasi diperlukan penataan ruang yang baik agar hubungan antar ruang dapat mendukung semua kegiatan yang terjadi dalam proses tersebut. Selain itu juga, untuk menciptakan suasana rehabilitasi maka diperlukan lingkungan yang baik dalam perancangan panti rehabilitasi agar pasien dapat berinteraksi dengan sesama pasien dengan baik. Kesimpulan dari penelitian ini adalah, merancang sebuah bangunan panti rehabilitasi untuk orang dengan HIV/AIDS agar mampu mengembalikan fungsi sosial ODHA di dalam masyarakat dengan pendekatan arsitektur perilaku.Kata Kunci : Arsitektur Perilaku, HIV dan AIDS, Panti Rehabilitasi ABSTRACTHIV and AIDS (Acquired Immune Deficiency Syndrome) are global issues. A limited knowledge of HIV transmission and treatment for people with HIV/AIDS in Indonesia has increased the number of HIV/AIDS cases annually and made the society stigmatize people with HIV/AIDS. Such stigma has made people with HIV/AIDS feel frightened, unconfident, ashamed, and disappointed with themselves. The designing method used in this thesis was the behavioral architecture. Some preliminary data from an initial survey was developed in the follow-up survey. Such data was then further studied and developed through a series of repeated surveys. The analysis process became an integral part of the data observation process. Thereafter, a theory was constructed based on the field data processing. To fulfill all the needs of rehabilitation process, a well-designed spatial planning is required, so the relationship between spaces can support all the activities in the process. In addition, to support the atmosphere of rehabilitation, a good environment is required in designing a rehabilitation center to allow patients to interact well with each other. To conclude, a rehabilitation center for people with HIV/AIDS was designed to restore the social function of people with HIV/AIDS in society based on behavioral architecture. Keywords: Behavioral Architecture, HIV and AIDS, Rehabilitation Center

Lazarus and Group Psychotherapy: AIDS in the Era of Protease Inhibitors

2003 ◽  
Vol 31 (3) ◽  
pp. 314-342 ◽  
Author(s):  
George V. Gushue ◽  
Sarah J. Brazaitis
Keyword(s):  
Protease Inhibitors ◽  
Group Process ◽  
Therapy Group ◽  
Immune Deficiency Syndrome ◽  
Deficiency Syndrome ◽  
Hiv And Aids ◽  
Medical Treatments ◽  
New Class ◽  
Immunodeficiency Virus ◽  
Acquired Immune Deficiency

A new class of medications, protease inhibitors, has dramatically improved the health of many people with Human Immunodeficiency Virus (HIV) and Acquired Immune Deficiency Syndrome (AIDS). This development has had a major impact on the lives of those affected by HIV/AIDS. This article considers how a group is affected by the larger systems of which it is a part. The article examines changes in the content, process, and salient leadership tasks of an ongoing therapy group for people with HIV and AIDS before and following the initial introduction of new medical treatments. It also considers how the group process continues to be affected by the more recent failure of these medications for many patients. Implications for research, practice, and training are discussed.

scholarly journals HIV and AIDS knowledge and sexual behaviours amongst secondary school learners in Harare, Zimbabwe

2012 ◽  
Vol 17 (1) ◽  
Author(s):  
Margaret Mlingo ◽  
Valerie J. Ehlers ◽  
Janetta Roos
Keyword(s):  
Secondary School ◽  
Immune Deficiency Syndrome ◽  
Deficiency Syndrome ◽  
Hiv And Aids ◽  
Structured Interviews ◽  
Prevention Education ◽  
Community Activities ◽  
Sexual Activities ◽  
Aids Knowledge ◽  
Grade 8

Efforts to stem the tide of the Human immunodeficiency virus (HIV) and Acquired immune deficiency syndrome (AIDS) pandemic in Africa emphasise the necessity that learners should be able to make informed decisions. Although learners in Zimbabwe’s schools are taught about HIV and AIDS, the extent of their knowledge needed to be determined. The major objective was to assess the knowledge of secondary school learners in Harare, Zimbabwe, about HIV and AIDS. Structured interviews were conducted with 75 Grade 8 (Form 1) secondary school learners from four schools in Harare.Most learners had obtained their HIV and AIDS knowledge from schools, but some did so from their parents, community activities, the radio or television. No learner had commenced with sexual activities and all had heard about HIV, but not all knew what HIV was, and even fewer could define AIDS. Less than one-third of the learners could mention the three most important HIV preventive measures. Most learners were willing to undergo voluntary counselling and testing (VCT), but few had done so. As no learner had commenced sexual activities, opportunities existed to empower Grade 8 (Form 1) learners with adequate HIV and AIDS knowledge. Generally the learners’ HIV and AIDS knowledge levels were high but some misconceptions existed. Schools should engage with radio and television programmes to address misconceptions about HIV and AIDS. Learners should be enabled to access VCT services. More effective HIV prevention education in Zimbabwe’s schools, could enable more youth to remain HIV negative.OpsommingPogings om die Menslike Immuniteitsgebrekvirus (MIV) en Verworwe immuniteits-gebreksindroom (VIGS) pandemiese golf in Afrika te stuit, beklemtoon die noodsaaklikheid dat leerders ingeligte besluite moet kan neem. Alhoewel leerders in Zimbabwe se skole onderrig word oor MIV en VIGS, behoort die omvang van die kennis vasgestel te word. Die hoofdoelwit was om sekondêre skool leerders van Harare, Zimbabwe, se MIV en VIGS kennis te bepaal. Gestruktureerde onderhoude is gevoer met 75 Graad 8 (Vorm 1) sekondêre skool leerders van vier skole in Harare.Die meeste leerders het hulle MIV and VIGS kennis by skole opgedoen terwyl ‘n paar dit van hulle ouers, gemeenskapsaktiwiteite, die radio en televisie gekry het. Geen leerders het met seksuele aktiwiteite begin nie, almal het van MIV gehoor, maar nie almal het geweet wat MIV is nie, en nog minder kon VIGS definieer. Minder as een-derde kon die drie belangrikste MIV voorkomende maatreëls noem. Die meeste leerders was gewillig om vrywillige berading en toetsing (VBT) te ondergaan, maar min het dit reeds gedoen.Aangesien geen leerder seksueel aktief was nie, bestaan geleenthede om Graad 8 (Vorm 1)leerders te bemagtig om ingeligte besluite te neem. Oor die algemeen was die leerders se MIV en VIGS kennisvlakke hoog, maar wanopvattings het bestaan Skole behoort saam te werk met radio en televisie programme ten einde wanopvattings aan te spreek. Leerders moet in staat gestel word om VBT dienste te benut. Doeltreffender MIV en VIGS voorligting in Zimbabwe se skole, kan meer jong mense in staat stel of HIV negatief te bly.

Stigma of HIV and AIDS—Psychiatric Aspects

2010 ◽  
Author(s):  
Sami Khalife ◽  
Jocelyn Soffer
Keyword(s):  
The United States ◽  
Hiv And Aids ◽  
Medical Community ◽  
Medical Attention ◽  
Negative Attitudes ◽  
Staff Members ◽  
Aids Epidemic ◽  
Human Contact ◽  
Adequate Care ◽  
Cellular Immunodeficiency

Since 1981, when previously healthy young adults were first stricken with a mysterious illness that was eventually described as “a new acquired cellular immunodeficiency” (Gottlieb et al., 1981), understanding of HIV and AIDS, both the in the medical community and general society, has come a long way. There remains, however, an unfortunate degree of stigma that persists since its development in the early days of the illness (Cohen and Weisman, 1986; Cohen, 1987, 1992; Cohen and Alfonso, 1998;Cohen, 2008). Early in the course of this epidemic, as it became evident that the immune deficiency had an infectious etiology and could lead to rapidly fatal complications, many became fearful of the possibility of contagion. An “epidemic of fear” (Hunter, 1990) thus began to develop along with the AIDS epidemic. During the first decade, even many physicians surveyed had negative attitudes toward persons with HIV and AIDS (Kelly et al., 1987; Thompson, 1987; Wormser and Joline, 1989). At the beginning of the HIV epidemic some persons hospitalized with AIDS experienced difficulty receiving even minimally adequate care, including getting their rooms cleaned, obtaining water or food, and receiving proper medical attention. Psychiatric consultations for AIDS patients with depression, withdrawal, and treatment refusal often revealed the heightened feelings of isolation and depression experienced by the patients, in part as a result of the reactions of staff members to their illness, including the palpable fear of contagion. Holtz and coauthors (1983) were the first to describe the profound withdrawal from human contact as the “sheet sign,” observed when persons with AIDS hid under their sheets and completely covered their faces. Thus, since the beginning of the AIDS epidemic, people with AIDS have been stigmatized. They have felt shunned and ostracized by not only medical caregivers but also the general community and even by their own families and friends. In some areas of the world, persons with AIDS have been quarantined because of the irrational fears, discrimination, and stigma associated with this pandemic. In the United States, persons with AIDS have lost their homes and jobs, and some children and adolescents have been excluded from classrooms.

President's Emergency Plan for AIDS Relief (PEPFAR) Policy Process and the Conversation around HIV/AIDS in the United States

2020 ◽  
Vol 5 (2) ◽  
pp. 149-166
Author(s):  
Laura E. Jacobson
Keyword(s):  
Public Health ◽  
Policy Process ◽  
Immune Deficiency Syndrome ◽  
The United States ◽  
Deficiency Syndrome ◽  
Policy Framework ◽  
Emergency Plan ◽  
Aids Epidemic ◽  
Process Factors ◽  
Hiv Aids

In 2003, the George W. Bush administration passed the President’s Emergency Plan for AIDS Relief (PEPFAR), a US government initiative to address the human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) epidemic primarily in Africa. PEPFAR’s US$18 billion budget remains the largest commitment from any nation towards a single disease and has saved countless lives. Given the historical and current political resistance to foreign aid, PEPFAR’s drastic spike in spending on HIV/AIDS raises questions over how the policy process resulted in bipartisan support. Using two policy process theories, punctuated equilibrium theory (PET) and the Narrative Policy Framework (NPF), this analysis helps explain the framing of the global HIV/AIDS epidemic and the factors that resulted in the creation of PEPFAR. The analysis of the PEPFAR policy process reveals a ‘tipping point’ in the early 2000s, when political actors, the media and advocacy coalitions benefitted from issue framing, narrative change and measures of political attention to elevate the global HIV/AIDS crisis to the public agenda. The findings highlight an increase in presidential attention, the evolution of the HIV/AIDS narrative away from stigma and the formation of powerful coalitions. Looking back on the combination of policy process factors that led to PEPFAR’s bipartisan success might lead to insights for dismantling the grand public health challenges of the present and future. This study’s findings have implications for currently stigmatised public health crises, such as the opioid epidemic.

Electrodissection tracheotomy

1996 ◽  
Vol 110 (8) ◽  
pp. 765-766
Author(s):  
Aijaz Alvi ◽  
Arsen Stegnjajic
Keyword(s):  
Immune Deficiency ◽  
Surgical Technique ◽  
Immune Deficiency Syndrome ◽  
Acquired Immune Deficiency Syndrome ◽  
Hospital Staff ◽  
Deficiency Syndrome ◽  
Aids Epidemic ◽  
Number Of Patients ◽  
Theatre Staff ◽  
Acquired Immune Deficiency

AbstractThe acquired immune deficiency syndrome (AIDS) epidemic and other potentially fatal blood-borne infectious diseases have produced a heightened awareness for preventing accidental inoculation of surgeons and operating theatre staff. It is incumbent upon the head and neck surgeon to use safe and effective surgical technique in these patients to prevent such an event. We are seeing an increasing number of patients with AIDS and hepatitis undergoing tracheotomy. We present a sharps-free technique for tracheotomy which is safe for the hospital staff and the patient.

Kaposi's sarcoma masquerading as pyogenic granuloma of the nasal mucosa

1998 ◽  
Vol 112 (3) ◽  
pp. 280-282 ◽  
Author(s):  
M. E. Wyatt ◽  
C. J. Finlayson ◽  
V. Moore-Gillon
Keyword(s):  
Head And Neck ◽  
Nasal Mucosa ◽  
Kaposi's Sarcoma ◽  
Kaposi’S Sarcoma ◽  
Immune Deficiency Syndrome ◽  
Original Description ◽  
Pyogenic Granuloma ◽  
Deficiency Syndrome ◽  
Aids Epidemic ◽  
Upper And Lower Extremities

AbstractKaposi's sarcoma (KS) is a neoplastic vascular disorder characterized by multiple reddish blue nodules which, according to the original description (Kaposi, 1872), usually present on the skin of the upper and lower extremities. It is not until the disease progresses that nodules appear on the skin of the head and neck, on mucosal membranes and as visceral lesions. However, with the large increase in the incidence of this tumour associated with the acquired immune deficiency syndrome (AIDS) epidemic, there have been increasing numbers of cases of Kaposi's sarcoma presenting primarily on the skin or mucosa of the head and neck. The most common sites reported are within the oral cavity, particularly on the palate. Other mucosal sites are rare. We present an unusual case where the primary manifestation of the Kaposi's sarcoma was in the nasal mucosa and stress the importance of this diagnosis not being overlooked.

Is the World Paying Enough Attention to the AIDS Epidemic in Ukraine and other Newly Independent States?

1998 ◽  
Vol 4 (3) ◽  
pp. 7-12
Author(s):  
Peter J. Foley
Keyword(s):  
Immune Deficiency Syndrome ◽  
Deficiency Syndrome ◽  
Sexually Transmitted ◽  
News Stories ◽  
Aids Epidemic ◽  
Independent States ◽  
The Government ◽  
Newly Independent States ◽  
Acquired Immune Deficiency ◽  
Private Sector Involvement

The author describes the Acquired Immune Deficiency Syndrome (AIDS) and sexually transmitted infections (STIs) situation in the Newly Independent States as serious, particularly in Ukraine and Russia. In those two countries, the author says an epidemic of STIs and AIDS is taking place. He cites statistics from the United Nations, news stories, and the government of Ukraine to support the argument that the situation in the Ukraine is alarming. He draws on his personal experience developing a social marketing project in Odessa, Ukraine to reinforce his argument that more attention needs to be paid to the STIs and AIDS epidemic. He urges private sector involvement and says the Futures Group is beginning such an effort in Odessa.

scholarly journals The spatial distribution pattern of human immunodeficiency virus/acquired immune deficiency syndrome in China

2016 ◽  
Vol 11 (2) ◽  
Author(s):  
Ying Wang ◽  
Yongli Yang ◽  
Xuezhong Shi ◽  
Saicai Mao ◽  
Nian Shi ◽  
...  
Keyword(s):  
Spatial Distribution ◽  
Spatial Autocorrelation ◽  
Immune Deficiency Syndrome ◽  
Deficiency Syndrome ◽  
Cumulative Number ◽  
Autocorrelation Analysis ◽  
Aids Epidemic ◽  
Immunodeficiency Virus ◽  
Acquired Immune Deficiency ◽  
Hiv Aids

Human immunodeficiency virus (HIV) infection and the acquired immune deficiency syndrome (AIDS) exhibit variable patterns among the provinces of China. Knowledge of the geographical distribution of the HIV/AIDS epidemic is needed for the prevention and control of AIDS. Thus, the cumulative number of reported cases of HIV/AIDS from the period 1985-2013, and the incidence rate of AIDS in 2013 were determined. Spatial autocorrelation analysis and hotspot analysis were conducted using ArcGIS10.2 to explore the spatial distribution of the HIV/AIDS epidemic. Both the thematic map and the global spatial autocorrelation Moran’s I statistics revealed a clustered distribution of the spatial pattern. A local spatial autocorrelation analysis indicated hotspots of AIDS incidence rate that were confined to the provinces of Guangxi, Yunnan and Sichuan. The hotspots encompassed Guangxi and Yunnan, while Henan Province displayed a negative autocorrelation with more variable numbers that included neighbouring regions. The <em>Getis-Ord G<sub>i</sub><sup>*</sup></em> statistics identified 6 hotspots and 8 coldspots for the incidence of AIDS, and 7 hotspots and 1 coldspot for the cumulative number of reported cases of HIV/AIDS. The spatial distribution pattern of the HIV/AIDS epidemic in China is clustered, demonstrating hotspots located in the Southwest. Specific interventions targeting provinces with severe HIV/AIDS epidemic are urgently needed.

scholarly journals AIDS and the Psychogeriatrician

1988 ◽  
Vol 12 (5) ◽  
pp. 187-189
Author(s):  
Cornelius L. E. Katona
Keyword(s):  
Public Health ◽  
Immune Deficiency ◽  
World Wide ◽  
Immune Deficiency Syndrome ◽  
Acquired Immune Deficiency Syndrome ◽  
Deficiency Syndrome ◽  
Public Health Issue ◽  
Aids Epidemic ◽  
Acquired Immune Deficiency ◽  
American Geriatric Society

It might at first sight appear that old age psychiatrists and geriatricians are relatively well protected from having to deal with the problems of patients suffering from the Acquired Immune Deficiency Syndrome (AIDS). It is therefore perhaps surprising that the major article in the newsletter of the American Geriatric Society is devoted to AIDS and concludes that “there is no question that the AIDS epidemic is the most important world wide public health issue of this century”.

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