Treatment Needs of People with HIV
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Objectives
– Explore the Physical, Affective, Cognitive, Environmental and Relational needs of people living with HIV
Physical
– Energy/Fatigue
– Symptoms
– Battling the virus
– Stress
– Medication side effects
– Interventions
– Changes in routines
– Acupuncture
– Nutrition
– Sleep (Sleep hygiene)
– Autoimmune issues
– Balance and coordination
– Environmental modifications
– Stability assistance
– Physical therapy
– Medication interactions
– Gastric upset
– Cardiovascular issues
Physical
– Sexual dysfunction impacting pituitary and gonadal hormone levels related to CD4 count
– Hypothyroid
– Hypertension
– Causes of hypertension in people with HIV include chronic inflammation, immune reconstitution, lipodystrophy and stress
– Pain
– Chronic pain in HIV can be caused by infections, cancers, gut problems, or peripheral neuropathy.
– Medication side effects including muscle pain, headache, stomach cramps or kidney stones
– Addiction—Chemical or process
Affective (Individual and family)
– General
– Some HIV medications may cause symptoms of mood disorders and disrupt sleep
– HIV medications can interact with psychotropics that induce or inhibit the enzyme cytochrome P450
– Anger
– About diagnosis
– At others
Affective (Individual and family)
– Anxiety
– Health anxiety (self and others)
– Abandonment fears
– Death anxiety
– Generalized anxiety
– Depression & Grief: Physical, Cognitive, Interpersonal, Financial losses
– Guilt / Shame: About getting or having the disease
– Happiness / Radical Acceptance
Cognitive
– General Needs: HIV Education
– HIV Associated Neurocognitive Disorders (HAND) impacts ~30% of people with HIV
Environmental
– Safety from
– Infection
– Physical threats
– Employment opportunities
– Discrimination by employers or colleagues
– Loss of physical or cognitive functioning (Reasonable Accommodations)
Relational
– Interpersonal challenges
– Loss of social support
– Stigma and discrimination associated with HIV
– Telling others you are HIV positive
– Dealing with death of SOs with AIDS
– Self esteem
– Acceptance
– Love & Belonging
– Significant others
General Intervention
– Physical
– Sleep & Circadian Rhythms
– Exercise
– Nutrition access and education
– Medication compliance
– Access
– Packaging
– Immune system enhancement
– Pain management
– Hormone balancing
– Affective
– Psychological flexibility
– Distress tolerance
– Coping skills
– Happiness
– Cognitive
– Individualized HIV and Health Education
– Scheduling
– Push notifications
– Environmental
– Reasonable accommodations
– Advocacy and public education
– Relational
– Communication skills
– Social support
– Education of social supports
Summary
– HIV impacts the person Physically, Affectively, Cognitively, Environmentally and Relationally
– Behavioral health professionals can aid in screening for comorbid/confounding conditions and making referrals as appropriate
– Behavioral health professionals can
– Enhance and maintain motivation for treatment compliance
– Assist in processing powerful emotions related to the diagnosis and associated issues
– Introduce cognitive behavioral tools and strategies to help the person cope
– Educate the individual, SOs and community about HIV transmission and treatment (reduce stigma and improve health behaviors)