HIV

http://library.med.utah.edu/WebPath/AIDS2011.PDF
http://ww1.cpa-apc.org:8080/publications/HIV/ment-ill.pdf
http://www.academicjournals.org/ijpc/PDF/Pdf2009/Nov/Moosa%20et%20al.pdf
http://schizophreniabulletin.oxfordjournals.org/content/23/4/675.full.pdf
http://apps.who.int/gb/ebwha/pdf_files/EB124/B124_6-en.pdf
http://www.ncbi.nlm.nih.gov/pubmed/11495342
www.who.int/gb/ebwha/pdf_files/EB124/B124_6-en.pdf

Psychosocial Aspects of

CASE COMMENTARY

MEDICINE

The Untold Story

Table of Content

• Abstract
• HIV/ AIDS should not be taken lightly as it as a huge psychocosial implication both on the patient and the society - the public's perception - if you are HIV positive, you are dirty, if the country have a high prevalence of HIV, reflects that the society is morally degaraded ... (bad)
• Epidmic/ Prevalence of HIV in normal subjects and in mentally ill pts and in schizophrenioa
• 
  

  Mental disorders, including substance use disorders, are risk factors for contracting HIV, and

  the presence of HIV/AIDS increases the risk of development of mental disorders.
• So, did the pt develop HIV first then Schizophrenia, or the other way around
• Not only the psychoscial implication, health also it at risk - opportunistic infection, tumor risk, multi organ disease/ involvement --> can affect child, husband, other workers, pregnant
• HIV and AIDS are commonly percieved by the public as two similar entities. But in actual fact, HIV and AIDS are somewhat rather different in terms of .. although they share the same ...
• When it comes to dealig with HIV and AIDS in the community, there are many sensitive issues that needs to be addressed by the Primary Care Physicians. Sensitrive issues starts from the pre test to post test - hence pre test and post test counselling is important to deal with the sensitiviteis related to HIV. AIDS
• Psychosocial implications of Dx someone with AIDS/ HIV...
• The sequale of Dx AIDS/ HIV  
• Stigma underlying HIV/ AIDS
• Medicolegal issues - notify, contact tracing, notify spouse/ partners/ family members - medicolegal issues with respect to HIV in mentally ill pt when it comes to notification
• HIV in mentally ill patient - how to prevent transmission, how to do contact tracing when history is not reliable
• pre and post test counselling in mentally ill pt
• Support groupd for HIV with mental illness/ schizophrenia
• Should HIV test be routinely done for schizophrenia/ metally ill pt? is it going to be cost effective.
• Risk reduction programme/ measure
• Introduction
• Her Story
• fleeting history - initially the way she answers questions and tells her story sounds very convincing. However, conflicting hx from day to day, from one dr to another intrigued me to find out the true story from her family members
• Seeking for the true story somehow was challenging - very seldom we see the family members around
• After they knew the dx, more family was seen at her bedside
• Hx from younger sibling -
• Hx from elder sibling -
• Hx from sibling staying with her -
• The Real Story
• family's perception - first impression, initial reaction to the dx, response x1/52 later
• family's concern
• Case Examinations and Investigations
• Case Management and Plan
• Patient's ideas, concerns and expectation
• patient's perception/ understanding of HIV and AIDS
• family's perception/ understanding of HIV and AIDS
• Issues to discuss/ Problem list
• Discussion
• The appropriateness of the term Sexual promiscuity (what seems promiscious to someone might not be promiscious to others with different religion and beliefs) vs High risk behaviours
• AIDS and HIV are used interchangeably in the society. AIDS and HIV have their own meaning
• Conclusion
• References

CHAPTER 1 - HUMAN IMMUNODEFICIENCY VIRUS 6

INTRODUCTION 6

BIOLOGY OF HUMAN IMMUNODEFICIENCY VIRUS 8

OTHER HUMAN RETROVIRUSES 21

EPIDEMIOLOGY OF AIDS 24

RISK GROUPS FOR HUMAN IMMUNODEFICIENCY VIRUS INFECTION 32

NATURAL HISTORY OF HIV INFECTION 33

PROGRESSION OF HIV INFECTION 37

IDIOPATHIC CD4+ T-LYMPHOCYTOPENIA 41

PREVENTION OF HIV TRANSMISSION 42

TREATMENT FOR AIDS 44

CHAPTER 2 - DIAGNOSIS OF AIDS 57

DIAGNOSTIC TESTS FOR HUMAN IMMUNODEFICIENCY VIRUS 57

PEDIATRIC HIV INFECTION AND AIDS 76

CRITERIA FOR AIDS-RELATED COMPLEX 80

OTHER CAUSES OF IMMUNOSUPPRESSION 81

CHAPTER 3 - OPPORTUNISTIC INFECTIONS IN AIDS 82

PNEUMOCYSTIS JIROVECI (CARINII) INFECTIONS 82

CYTOMEGALOVIRUS INFECTIONS 86

MYCOBACTERIAL INFECTIONS 88

CRYPTOCOCCUS NEOFORMANS INFECTIONS 95

HERPESVIRUS INFECTIONS 97

CANDIDA INFECTIONS 101

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TOXOPLASMA GONDII INFECTIONS 104

HISTOPLASMA CAPSULATUM INFECTIONS 106

COCCIDIOIDES IMMITIS INFECTIONS 108

GASTROINTESTINAL PROTOZOAL INFECTIONS 109

BACTERIAL INFECTIONS SEEN WITH AIDS 112

CHAPTER 4 - NEOPLASMS ASSOCIATED WITH AIDS 121

KAPOSI’S SARCOMA 121

MALIGNANT LYMPHOMAS 124

OTHER NEOPLASMS 129

CHAPTER 5 - ORGAN SYSTEM PATHOLOGY IN AIDS 131

RESPIRATORY TRACT PATHOLOGY IN AIDS 131

GASTROINTESTINAL TRACT PATHOLOGY IN AIDS 149

CENTRAL NERVOUS SYSTEM PATHOLOGY IN AIDS 164

PERIPHERAL NERVE AND MUSCLE PATHOLOGY IN AIDS 181

OPHTHALMIC PATHOLOGY IN AIDS 188

LYMPH NODE PATHOLOGY IN AIDS 191

BONE MARROW AND PERIPHERAL BLOOD IN AIDS 198

THYMUS IN AIDS 202

ENDOCRINE ORGAN PATHOLOGY IN AIDS 203

HEPATOBILIARY SYSTEM PATHOLOGY IN AIDS 206

CARDIOVASCULAR PATHOLOGY IN AIDS 212

GENITOURINARY PATHOLOGY IN AIDS 217

DERMATOPATHOLOGY IN AIDS 224

PANCREAS IN AIDS 236

PREGNANCY AND THE PLACENTA IN AIDS 238

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HEAD AND NECK PATHOLOGY IN AIDS 239

BONE, JOINT, AND SOFT TISSUE PATHOLOGY IN AIDS 241

CYTOPATHOLOGY IN AIDS 244

PEDIATRIC AIDS 245

CHAPTER 6 - SAFETY PROCEDURES WITH AIDS 251

EDUCATIONAL GOALS 251

UNIVERSAL PRECAUTIONS 252

OSHA REGULATIONS 253

OCCUPATIONAL AND NON-OCCUPATIONAL HIV EXPOSURES 257

INVASIVE AND SURGICAL PROCEDURES 260

THE SURGICAL PATHOLOGY LABORATORY 262

THE AIDS AUTOPSY 263

MORTUARY AND FORENSIC LABORATORY PROCEDURES 264

ATHLETICS AND HIV INFECTION 266

CHAPTER 7 - MEDICOLEGAL ISSUES AND AIDS 269

DEATH INVESTIGATION AND CERTIFICATION IN AIDS 269

DETERMINATION OF CAUSE AND MODE OF DEATH WITH HIV INFECTION 269

ETHICAL ISSUES ARISING FROM THE AIDS EPIDEMIC 272

HIV TESTING AND COUNSELING 274

BLOOD AND TISSUE BANKING AND AIDS

Research is urgently needed to adequately respond to the AIDS epidemic among
people with persistent and recurrent psychiatric disorders such as schizophrenia,
depression or bipolar disorder.  This program announcement (PA) is sponsored by
the NIMH to stimulate investigator-initiated research that targets persons with
severe mental illness (SMI) either before or after HIV infection.  It solicits
studies on the SMI population that address the epidemiology of HIV infection,
epidemiology of sexual and drug-use risk behaviors and other relevant risk
behavior patterns, risk reduction and transmission prevention interventions,
treatment of mental illness and the neuropsychiatric sequelae due to HIV
infection, service provision research or other issues relevant to persons with
SMI.  An important objective of this PA is to encourage integration both across
and within these different areas and the translation of these research findings
to applied mental health and public care systems.  Multidisciplinary research
teams and collaborative alliances are encouraged.

review. Data

from a dozen or so studies conducted since 1990 confirm

and strengthen the impressions that persons with

schizophrenia should be considered a group with a

much higher than average risk for developing

HIV/AIDS and that they have special needs for protection

as a public health measure. Mental health service

providers need to be aware of these findings.

Schizophrenia Bulletin, 23(4):675-684,1997.

Ana-Maria Schweitzer, MA

Michael B. Mizwa

Michael W. Ross, MA, PhD, MPH

HIV/AIDS: Adults