HIV/AIDS is a disease that affects the human system, caused by the human immunodeficiency virus. The disease is transmitted through engaging in unprotected sex, receiving a transfusion of HIV-infected blood, sharing needles and other sharp objects, and the exposure of a fetus to the virus before or during birth. The disease is spreading at a faster rate all over the globe, but practitioners are devising improved ways to alleviate the disease among human beings. Mental health can be defined as the psychological well-being of individuals. The World Health Organization (WHO) perceives mental health as the capability of individuals to realize their abilities and cope with various aspects of work for effective existence. American Psychiatric Association (2006) indicates that most individuals living with HIV/AIDS are prone to mental and health problems in cases where care is not effectively taken. The key mental and health issues that the individuals infected with HIV/AIDS may be exposed to include depression, anxiety, and substance abuse. Guiding and counseling is an effective practice that would help counter any fears associated with the dreaded HIV/AIDS disease. The abandonment and hatred of individuals infected with HIV/AIDS has been a key factor in leading to mental and health problems among such individuals. Abandoned individuals are likely to suffer from depression, which is associated with a low mood among individuals suffering from HIV/AIDS. Depression leads to the aversion of individuals from vital activities, because of the feeling that they may not be wanted in society. This is a negative feeling as it stops individuals from achieving their set targets. Additionally, individuals infected with HIV/AIDS may suffer from anxiety, which involves unnecessary fear and concern. Anxiety is a psychological condition characterized by cognitive, emotional, behavioral, and somatic components. These persons may also engage in substance abuse with the aim of alleviating the stresses, associated with their health status. This is negative as it negates the process of trying to reduce the effects of HIV/AIDS among individuals. These conditions are more prevalent among individuals infected with HIV/AIDS compared to the uninfected population. Most of the infected individuals face these mental and health problems because of the feeling of low self esteem and neglect in society. People infected with HIV/AIDS could be treated through the administration of ARVs, access to healthy diets, frequent exercises, guidance and counseling. Guidance and counseling would give infected individuals hope that they are still capable and appreciated by the society. A neurocognitive deficit is a HIV/AIDS associated disorder, and it involves the impairment of the cognitive functions in the human body. It is vital for individuals to pursue the correct treatment and live effectively.
This paper explicates HIV and the associated mental and health issues among individuals. More so, it gives an explanation of the treatment of the mental and health conditions among individuals.
Mental and Health Issues
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Depression is one of the key mental issues associated with HIV. It refers to the exhibition of low mood and the tendency to avert some of the activities that were considered vital by the individual. HIV causes individuals to live with the feeling that they are cursed and not wanted in the society, hence, making them inefficient in the performance of different activities. Depression is associated with HIV and makes infected individual feel sad, hopeless, helpless, worthless, hurt, irritable, and guilty for their actions. They do not feel free to interact with other individuals in the society, because of the sad feeling that they are incomplete and could have messed up at some point. It is a negative mental condition among infected individuals as it affects behavior, thoughts, feelings, the perception of the world, and the physical ability of the individual. This means that depression makes it difficult for individuals to utilize their energy fully. They do not exhibit their full potential, because of the feeling that they suffer from HIV, which is an undesirable disease. Horwitz & Scheid (1999) affirm that depression makes individuals lose interest in activities that they used to perceive as pleasurable, hence hindering effective performance of activities. More so, depression leads to the loss of appetite, thus, negating the health conditions of most individuals suffering from HIV. Depression may also aggravate HIV/AIDS by leading to other conditions such as insomnia, fatigue, excessive sleeping, pains, and even digestive disorders. Depression is also negative, because it retards the rate at which individuals can reason and make effective decisions. It may also lead to the feelings of committing suicide and other undesirable activities due to the feeling that HIV is the end of life (Volberding, 2008).
Anxiety refers to the persistent feeling of fear and concern among individuals. Most of the individuals, suffering from HIV, experience feelings of fear, dread, and uneasiness, which are tantamount to anxiety. Notably, anxiety is a psychological state and several component such as the behavioral component, cognitive component, somatic component, and emotional component characterize it. This means that HIV/AIDS makes it difficult for individuals to settle and stay focused on particular events in the society. They experience feelings of undesirable fear and concern, because of the assumption that all individuals in their surrounding know their health status. They do not feel free to interact with other individuals as they are dominated with unnecessary fear. HIV is also associated with anxiety as most of the infected individuals feel intimidated and unfit to stay in a society composed of healthy individuals. Anxiety causes several cognitive effects among individuals experiencing it. For instance, most of the individuals that experience restlessness have trouble concentrating even on the simplest tasks, irritability, and expectation of the worst and tense feelings (Ruiz & Strain, 2011). This means that anxiety makes individuals, living with HIV, have little hope about the future. Most of them only tend to think about the negativities associated with HIV and perceive their lives terminated by the disease. It makes the thoughts of individuals concentrated with negative assumptions that are not likely to happen. Therefore, the activity level of the infected individuals is reduced due to the restlessness and the lack of concentration. They are not able to achieve their goals because of the fear that HIV would eventually terminate their lives. The hope of individuals is terminated, and they are not able to make rational decisions, because of the unnecessary fear that they have a dreaded disease all over the globe.
According to Paul, Sacktor, Valcour, & Tashima (2009), substance abuse is another condition associated with HIV. Substance abuse refers to the consumption of drugs in quantities not approved and supervised by medical practitioners. It is associated with HIV as most of the infected individuals suffer from depression and stresses. They always have a perception that excessive use of drugs would play an instrumental role in alleviating their stresses brought about by HIV. Thus, HIV causes most individuals to indulge in drugs with the aim of alleviating the depression, associated with the disease. The other significant reason for the overuse of drugs among individuals suffering from HIV is the feeling that they are neglected and need to fill the gap through the continued consumption of drugs. Most of them perceive drugs as the only true companion that would help them achieve their desires. The lack of hope and restlessness is also another motivation for individuals to indulge into drug abuse. HIV is associated with drug abuse as individuals feel that they do not have a future because of the HIV disease (Patel, Woodward, Feigin, Quah, & Heggenhougen, 2010). They find solace in the consumption of drugs because it helps them forget some of their problems attached to HIV. More so, increased indulgence in substance abuse leads to the rise in the spread of HIV. This is common where such individuals indulge in unprotected sex or share needles as they administer the drugs into their bodies. This is instrumental in promoting the spread of the disease all over the globe at a faster rate. Additionally, most of the HIV-infected individuals are likely to shorten their lives compared to those who do not use drugs. This is because the treatment and alleviation of HIV using measures such as antiretroviral therapy would not be efficient. Substance abuse weakens the systems of HIV-infected individuals and negates their health conditions. It aggravates the negative aspects of the HIV/AIDS disease among individuals (Nunn, 2008).
The term prevalence is used to refer to the number of cases associated with the overall population at any given time. The prevalence of depression and anxiety is higher among the infected population compared to the uninfected population. On the other hand, substance abuse is more prevalent among the uninfected population compared to the infected population (Nott, 2000).
Depression is more prevalent among the infected population compared to the uninfected one. Infected individuals tend to be more depressed because of the feeling that they could have done something wrong at some point in their lives. Auerbach & Auerbach (1994) indicate that HIV tends to lower the mood of most individuals, and they tend to shun away from most of the activities that they considered vital at some point in their lives. They tend to lose hope and do not concentrate on most of the vital activities in their lives. Depression is more prevalent among individuals infected with HIV and they tend to be sad, and hopeless at most instances. This affects their thoughts, behavior, and the perception about the world. On the other hand, most uninfected individuals do not suffer from depression. Effective health gives most of the uninfected individuals the confidence to pursue different courses of action without fear. They act with a high level of confidence and hope that they would ultimately achieve their objectives with the correct state of health. Most of the uninfected individuals who suffer from depression, suffer because of some undesirable occasion at some point of their lives. The high prevalence of depression among infected individuals tends to lead to earlier deaths among such individuals than anticipated. Guidance, counseling, and the acceptance of HIV would play an instrumental role in alleviating depression among such individuals (Newman & Newman, 2011).
Cohen & Gorman (2007) indicate that anxiety is more prevalent among infected individuals compared to uninfected individuals. Most of the affected individuals tend to exhibit high levels of undesirable fear and concern about their health conditions. HIV affects the confidence of individuals and they are not likely to be motivated to pursue their lives to the fullest. Most infected individuals suffer from anxiety, because of the numerous fearful expectations that they hold about the future. Most of them always have fears about dying and other negative happenings at some point of their lives due to infection by HIV/AIDS. High levels of anxiety among infected individuals provoke infected individuals to withdraw from most of the activities because of the fears that they hold about their conditions. Anxiety among infected individuals leads to an unrealistic view of problems, irritability, the feeling of rejection, and the difficulty in concentrating. This limits the productivity of infected individuals, as they are not motivated to engage in activities that would yield effective results. The rates of anxiety are less prevalent among uninfected individuals. Most uninfected individuals do not live with fear in their lives (Narain, 2004). They live with high levels of hope and confidence, boosted by their proper health conditions. Proper health gives individuals the hope and motivation that they are able to achieve their goals at any instance. They have belief in themselves and are always motivated to forge forward and achieve their established objectives. Cottler (2011) asserts that most of the infected population could suffer from anxiety, because of some common negative events in their lives. This anxiety may be countered effectively through advising individuals and giving them hope about success. Anxiety tends to stay for longer periods among infected individuals compared to uninfected individuals. Therefore, infected individuals exhibit higher levels of anxiety compared to individuals who are infected in society.
Substance abuse is more prevalent among the uninfected population. Drug and substance abuse is more widespread among the population that is not affected by HIV because of the availability of large amounts of energy and motivation. Fernandez & Ruiz (2006) indicate that most uninfected individuals tend to indulge in drug use without the prescription of medical practitioners. They share needles and other sharp objects in the administration of drugs into their bodies. Some of the individuals relate drug use to relaxation and a feeling of pleasure in their lives. They find leisure and pleasure in the rampant abuse if drugs. Substance abuse is more prevalent among the uninfected population because of the excessive energies that most of these individuals possess. Some individuals, who are uninfected, also consider the excessive use of drugs as a show of superiority and recognition in their lives. The high prevalence of substance abuse has also led to increased levels of infection among the uninfected individuals. The situation occurs, as some of them tend to engage in unprotected sex with infected individuals. More so, they tend to share needles, which spread HIV. On the other hand, substance abuse is less prevalent among infected individuals. Infected individuals are cautioned against indulging in drug abuse, because it negates their health conditions. They tend to be more cautious about their health status and the need to stay safe.
Specific Treatments found Effective for People Living with HIV
Various treatments are good for various people living with HIV. Goodkin (2009) asserts that various ailments result due to HIV. These include mental disorders, neuropsychiatric complications, drugs, substance abuse, and cognitive impairment. Thus, it is advisable to treat all diseases that occur to various people living with HIV because they affect the functioning of ARVs in one way or the other. Research also alludes the fact that some traditional medicines can be utilized in the treatment of HIV and cure AIDS. This is possible for the traditional medicines help in suppressing of opportunistic infections, which are considered part of AIDS. Some of the traditional treatments available include the use of herbs and spices. For a thorough understanding of the effective treatments available for people living with HIV, it is essential that we discuss the various diseases that arise because of HIV AIDS (Narain, 2004).
Mental disorders rank top among the diseases that result from HIV. According to research, there is a close interlink between HIV infection and mental problems, which also includes substance-use disorders. The mental problems and substance-use disorders are said to interfere with the treatment of HIV and in most cases, they promote the spread of the disease. Notably, research confirms that some mental disorders are because of HIV infection. Thus, it is essential to treat mental and substance-use disorders because they tend to affect help-seeking behavior and diagnostic treatment services. For instance, the research estimates that there is a low uptake of ARVs amongst patients with mental disorders (Marcotte & Grant, 2009).
According to research, the progression of HIV AIDS and response to treatment are affected by substance-use disorders. Drug dependence is blamed for reducing the highly active antiretroviral therapy, while at the same time increasing the rates of coinfection with viruses such as hepatitis B and C. Thus, research suggests that it is essential to treat both HIV and substance-use at the same time in order to reduce chances of a person becoming accustomed to substance-use, which will lower his or her dependence level on the ARVs. Treatment of alcohol dependence is extremely essential for patients with HIV/AIDS. The research proves that there are many cases of deaths linked to HIV/AIDS and alcoholism. This is blamed on the fact that alcohol has a direct effect on HIV disease progression, which is mediated through the immune system. Another reason is that alcohol causes a person to undermine adherence to treatment. Thus, it is essential for people suffering from HIV/AIDS to be treated, if they are addicted to substance-use (Knox & Sparks, 1997).
Some bacterial diseases such TB should also be treated when a person is diagnosed with HIV. Jain & Stephens (2008) indicate that people with HIV have a higher risk of developing TB as compared to people without HIV. For instance, 1.1 million cases of people with HIV were reported to have developed TB out of the total 8.8 million cases reported. Thus, HIV/AIDS patients are advised to undergo the latent treatment of TB, as this reduces the chances of reactivation of latent infection. Research also asserts that there is a need for TB test, because it facilitates diagnosis of TB.
Syphilis is an STD that is closely associated with HIV. According to research, when the two diseases intersect it is considered as an epidemic. Syphilis is considered a great imitator for it makes it hard for professionals to diagnose and treat it. Research also indicates that the infection of one disease can result to the infection of the other. Thus, it is essential for the treatment of syphilis, as it results in the transmission and acquisition of HIV. This reflects the interplay between the two diseases. Research also points out that during the course of secondary syphilis, T palladium causes an activation of activated CD4 cells, which enhance the transmission of HIV (Kennedy & Moore, 2010). Researchers are of the opinion that patients with syphilis should receive the same treatment as those who are not infected with HIV. Thus, two treatments are abound. These include benzathine penicillin G, which is a treatment for early syphilis, while aqueous crystalline penicillin G is utilized for neurosyphilis. However, researchers advance that patients suffering from syphilis and are HIV positive require a more aggressive treatment. An example of this treatment is the intramuscular benzathine penicillin injection.
Recent research has given some credence to traditional methods of treating HIV/ AIDS although it has not been ascertained if it avails a complete healing. Some researchers are of the opinion that herbs and spices play a critical role in the preservation of foods, appetite stimulation, and improvement of digestion. However, it is noted that traditional treatment, available for patients with HIV/AIDS, does not have the same effect on all patients. It is also important that the herbs and spices used for treating HIV/AIDS be used moderately, because of the anticipated side effects. Some of the herbs and spices used in the treatment of HIV include Aloe, which relieves constipation and garlic, which functions as an antibiotic, antifungal, and antiviral.
However, much credence is given to antiretroviral therapy (ART). This comprises of three or more ARV drugs. Research concerning ART indicates that the drug does not cure the infection, but has the potential to limit the viral replication. In addition, ART facilitates the strengthening of the immune system, which is essential in wading off infections. Thus, ART facilitate people to lead healthy and productive lives because they are not subdued with opportunistic infections that might result because of weakening of their immune system.
HIV Associated Neurocognitive Disorder
HIV associated neurocogntive disorder is known by various names. These include HIV dementia, HIV associated dementia or AIDS dementia complex. Research considers is as an HIV and AIDS neurological disorder. HIV is blamed for its induction and the macrophages and microglia fuel it. Thus, HIV connection to fuelling of associated neurocognitive disorder is blamed on the fact that HIV infects the macrophages and microglia actively, which results to the secretion of neurotoxins that are associated with hosting and the viral origin of the infection. Various effects of HAND include the disabling of the cognitive impairment, which results to motor dysfunction, behavioural change, and problems related to speech. A further distress that results from cognitive effects includes concentration, memory problems, and mental slowness. On the other hand, motor symptoms comprise of tremors, poor balance, and clumsiness. Lastly, behavioral changes comprise of spontaneity, lethargy, diminished emotional responses, and apathy.
Researchers have established that HAND results many years after a person has been infected with HIV. This is attributed to the fact of the diminishing of the CD4+ T cell levels. High plasma viral loads also contribute to HAND. This has been asserted as the onset of AIDS amongst some patients.
Prevalence of Dementia
There have been many cases reported regarding the progression of dementia during the latter stages of HIV infection. There is uncommonness of dementia in the asymptomatic phase despite the possibility of neurocognitive disturbances (Watson & Preedy, 2009). Data collected from two cohort studies, which included persons primarily on mono and dual ARV therapy and persons primarily on HAART regimens assist in knowing the prevalence of HAND in the HAART era. It should be noted that the first group of persons comprised of the DANA cohort, while the second group was referred to as Northeastern AIDS Dementia (NEAD).
The results revealed a less number of people amongst the DANA with HIV minor/ cognitive/ motor disorder as compared to those in the NEAD cohort. However, there was an equivalent percentage of persons with HIV dementia.
A recent research that observed data regarding neurological disorders over a 10 year period post-HAART therapy initiation placed HAND as the second most prevalent neurological disorder. It trailed behind distal sensory polyneuropathy. A difference resulted from the fact that people diagnosed with AIDS had much higher incidence of all neurologic disorders as compared to those with HIV only.
A further research on the topic asserts that HAART has played a crucial role in reducing incidences of HIV dementia from 15 percent to 50 percent. The use of mixed subcortical and cortical features is blamed for the reduction of the severity of HAND. In addition, higher CD4 cell counts played a critical part.
A much recent research is of the opinion that western countries have 10-24 percent prevalence, while the Indian based infections comprise of 1-2 percent infections. Jain & Stephens (2008) are of the opinion that there has been a reduction of HAND incidence in developed countries ever since the advent of HAART; however, the prevalence is escalating. Grant & Adams (2009) assert that HAART plays a critical role in delaying the ADC onset and improves the mental functioning of people already diagnosed with HAND.
Psychosocial Effects of Neurocognitive Disorder
Various psychosocial effects of HAND abound. Firstly, a person has memory problems that can make one forget when he or she promises something. It also makes a person forget what one was supposed to do. Distractibility is also considered as an effect, when a person does not maintain attention. Anger, emotional ability, and irritability also abound as effects of HAND. Thus, a person cannot socialize well with other people, because one gets feats of anger easily or gets irritated quickly by those around him or her. Fatigue and psychomotor slowness are other factors effecting a person not willing to engage in constructive activities with other people. Sadness is a great deterrent to socializing as a person is usually in a pensive mood; thus, cannot interact freely. Language problems have also been noted and they affect the way a person communicates. There is decreased attention and concentration, which makes a person lack interest in what people are saying or doing. Clumsiness is also a psychosocial effect and affects the picture people have of a person. Social withdrawal abounds as the major social effect. A person with HAND will tend to seclude himself from people because they feel that they get solace from being alone. Other psychosocial effects revealed by research include visuospatial difficulties, psychotic symptoms, and severe verbal memory loss, which results in the later stages of the ailment.
Nichols, Watson, Vergon, Vallee, & Meah (2002) affirm that HIV-associated neurocognitive disorders do not have a treatment. However, much credence is given to ART, because it has the potential of reversing the disease process. In addition, therapies also contribute to the reversal of the ailment. A number of specialists are involved in the treatment of MCMD and HAND. The multidisciplinary requirements of the ailment allow this type of treatment. Specialists involved in the treatment of the disease include social workers, neurologists, substance-use specialists, nurse practitioners, psychiatrists, and psychologists.
Thus, Holmes, et al. (2007) confirm that it is essential in rectifying all ailments that may affect the brain during the process of treating HIV. These include adverse medication effects, psychiatric comorbidities, and endocrinologic abnormalities (Johnson, 2010).
Research also advances a pharmacological approach to HIV-associated neurocognitive disorders. This includes the use stimulants, which aid in alleviating the symptoms of memory deficits, fatigue, and decreased concentration. Stimulants used for the treatment include dextroamphetamine and methylphenidate. Antidepressant medications are also advisable for HIV patients with comorbid depression. Agitation and hallucinations can be treated using antipsychotic medications.
On the other hand, the use of nonpharmacologic drugs is encouraged and these include instructing patients on the need of remaining appropriately active, good nutrition, and using memory aids. An example of memory aid is a list (Joint United Nations Programme on HIV/AIDS., 2005). It is also essential for a patient to involve himself in cognitive building skills such as solving puzzles and intellectual conversations. A patient can also be treated through a detailed explanation, regarding the benefits of a structured routine. A simplification of tasks also abounds as a treatment for neurocognitive disorders (Kennedy & Moore, 2010).
In conclusion, HIV has been established as a disease caused by the human immunodeficiency virus and it affects the human system. The transmission of the disease takes many forms such as coming into contact with infected blood through cuts, having unprotected sex, and mother to child contamination during the conception. Three mental and health issues are identified regarding HIV/AIDS. These include anxiety, depression, and substance abuse. Depression is one of the key mental issues associated with HIV. It refers to the exhibition of low mood and the tendency to avert some of the activities that were considered vital by the individual. Substance abuse is another condition associated with HIV. Substance abuse refers to the consumption of drugs in quantities not approved and supervised by medical practitioners. Prevalence refers to the number of cases associated with the overall population at any given time. The prevalence of depression and anxiety is higher among the infected population compared to the uninfected population. Various treatments of people suffering from HIV abound. HIV is blamed for its induction and the macrophages and microglia fuel it. Thus, HIV connection to fuelling of associated neurocognitive disorder is blamed on the fact that HIV infects the macrophages and microglia actively, which results to the secretion of neurotoxins that are associated with hosting and the viral origin of the infection. Much credence is given to ART, because it has the potential of reversing the disease process. In addition, therapies also contribute to the reversal of the ailment. A number of specialists are involved in the treatment of MCMD and HAND. Other treatments for neurocognitive disorders include a pharmacological approach and a non-pharmacological approach. Pharmacological approach entails the use of stimulants and antipsychotic medicines. The use of nonpharmacologic drugs is encouraged and these include instructing patients on the need of remaining appropriately active, good nutrition, and using memory aids. The use of nonpharmacologic drugs is encouraged, and these include instructing patients on the need of remaining appropriately active, good nutrition, and using of memory aids.
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