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PSYCHOSOCIAL ISSUES IN HIV/AIDS

PSYCHOSOCIAL ISSUES IN HIV/AIDS. Karina K. Uldall, MD, MPH Department of Psychiatry University of Washington. Pre-HAART. More rapid, fatal course of disease Emphasis on treating opportunistic infections and providing palliative care Quality of life affected by various symptoms. Post-HAART.

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PSYCHOSOCIAL ISSUES IN HIV/AIDS

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  1. PSYCHOSOCIAL ISSUES IN HIV/AIDS Karina K. Uldall, MD, MPH Department of Psychiatry University of Washington

  2. Pre-HAART • More rapid, fatal course of disease • Emphasis on treating opportunistic infections and providing palliative care • Quality of life affected by various symptoms

  3. Post-HAART • More chronic disease course • Complex treatment regimen with many adverse effects • Prognostic uncertainty

  4. Population Issues • Disproportionate impact on marginalized groups • Less access to and engagement with care system • Co-morbidities such as hepatitis, mental illness, substance use • Complex psychosocial issues result

  5. Positive Aspects of HIV/AIDS • More services and support available • Renewed spirituality • New, healthier relationships • Priorities clarified • Conflicts resolved

  6. Stigma/Discrimination Estrangement from family/community Fear of contagion Fear of death Feeling like a burden Loss of dignity Guilt Grief over multiple losses Negative Aspects of HIV/AIDS

  7. Cultural Issues • Meaning of illness and death • Family or community role in illness • Value of autonomy • Communication patterns • Mistrust of authority/medical systems

  8. Accompaniment Advocacy Assessment Care Coordination Crisis Intervention Engagement Listening Motivational Interviewing Patient/Family Education Problem Solving Referrals Skills Building Support Interventions

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