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HIV and AIDS

HIV and AIDS. HIV. HIV (Human Immunodeficiency Virus) The retrovirus that infects and attacks the immune system, eventually causing AIDS HIV injects its genome into lymphocytes so that it reproduces when the cells are activated. AIDS (Acquired Immune Deficiency Syndrome).

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HIV and AIDS

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  1. HIV and AIDS

  2. HIV • HIV (Human Immunodeficiency Virus) • The retrovirus that infects and attacks the immune system, eventually causing AIDS • HIV injects its genome into lymphocytes so that it reproduces when the cells are activated

  3. AIDS (Acquired Immune Deficiency Syndrome) • A life-threatening disease caused by the human immunodeficiency virus (HIV) in which the body’s CD4 lymphocytes are destroyed, leaving the victim vulnerable to opportunistic infections

  4. The Course of HIV/AIDS

  5. US Statistics Approx. ½ million people are living with AIDS in America Around 77% of adults and adolescents living with AIDS are men http://www.avert.org/statindx.htm

  6. Global Statistics (published in July 2008) • People living with HIV/AIDS in 2007 33.0 million • Women living with HIV/AIDS in 2007 15.5 million • People newly infected with HIV in 2007 2.7 million • AIDS deaths in 2007 2.0 million • 25 million have died since the first cases of AIDS were identified in 1981

  7. Women and AIDS • Women account for nearly half of all people worldwide living with HIV/AIDS • Globally, girls and women are more likely than men to contract HIV • Women are often less able to protect themselves because they are economically and culturally subordinate to men • More of the virus is found in ejaculate • Women progress to AIDS at a lower viral load than men • 59% of AIDS victims in sub-Saharan Africa are women. • Africa has 11.6 million AIDS orphans. • Their Brothers’ Keepers, 2005 documentary

  8. Behavioral issues in HIV infection -- The ABCs • A bstinence or delaying first sex • B eing safer by being faithful to one partner or by reducing the number of sexual partners • C orrect and consistent use of condoms for sexually active young people, couples in which one partner is HIV-positive, sex workers and their clients, and anyone engaging in sexual activity with partners who may have been at risk of HIV exposure.3

  9. Intervention Strategies for preventing HIV/AIDS • Psychosocial Interventions • Increasing safer sex practices (e.g., attempt to counteract emotionally intense, rushed nature of many sexual encounters that are not conducive to clear thinking and negotiating about safer sex) • Decreasing drug and alcohol use • Enhancing knowledge (complacency about STIs) • Increasing risk perception • Increasing self-efficacy (e.g., dealing with coercion) • Determining which groups to target? • Community interventions? What to do…?

  10. Psychosocial Barriers to HIV/AIDS Prevention • Despite massive educational efforts, rates of condom use and other safer sex behaviors are low. • Media depictions of sexual encounters do little to promote interventions aimed at promoting safe sex. • Misconceptions of HIV/AIDS are common. Optimistic bias and perceived invincibility are common.

  11. Highly active HIV prevention Holmes, U of W

  12. Psychosocial Factors in disease progression • Stress, depression, etc. • Adherence to medical regimen • Coping with HIV/AIDS

  13. Psychosocial Factors in AIDS • Studies have shown a clear relationship among psychosocial factors, disease progression, and HIV mortality(Ironson et al. chapter) • Cognitions • Coping • Life Stress • Depression and Distress • Social Support (mixed results)

  14. Adherence to Medical Regimen • Three objectives: • Support the immune system • Prevent, control, or eliminate opportunistic infections • Clear the body of HIV

  15. Medical Interventions • The HAART Regimen (highly active antiretroviral therapy) • Multiple anti-HIV drugs (e.g., AZT, protease inhibitors) are often used in an “AIDS drug cocktail” • HAART regimen is expensive ($10,000 to $15,000 per year) and difficult to follow (25 pills per day) • Must take consistently, or HIV will adapt and become resistant to drugs • 80-90% of individuals who adhere have undetectable plasma HIV viral loads in 6 to 12 months

  16. Strategies to Combat HIV Reproduction

  17. Coping With HIV and AIDS • Psychosocial impact • Stigma • Impact on family • Acknowledging the possibility of dying young (and friends dying young) • Depressive, suicidal thoughts common, especially among those who feel a withdrawal of family and social support

  18. Coping with HIV/AIDS • Problem-solving skills • Relaxation training • Skills for obtaining health care, SS disability, etc. • Strategies for decreasing unprotected sex (besides infecting others, this can increase the risk of secondary infections that can activate the AIDS virus) • Skills for reducing alcohol consumption (reduces immune function in PWAs) • Increase sense of control • Group support

  19. Antoni et al. (2000) • HIV-positive men received a 10-week CBSM intervention (relaxation training, cognitive restructuring, techniques to manage anger, etc.)

  20. How Might CBSM Work? • CBSM may lower norepinephrine levels (which tend to be elevated in HIV-infected people and inhibit the proliferation of lymphocytes) • CBMS may contribute to increased sense of mastery over the disease and lead to better diet, more exercise, and other self-care behaviors

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