Psychological reaction to real or probable risk of HIV infection
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1 Psychological reaction to real or probable risk of HIV infection Dorota Merecz HIV/AIDS, well-being and mental health problems 1
2 Critical events in HIV positives diagnosis Disclose HIV diagnosis to family and friends Beginning of treatment Somatic disease Recognition of new symptoms/ progression of disease Hospitalization (especially first one) Death of significant others AIDS diagnosis Changes in life style confronting mortality HIV related dementia Neurobehavioral disorders Mild cognitive and motor impairements 2
3 HIV related dementia Impairment/ disorder emotional apathy irritation mania symptoms behavioral cognitive motor Psychomotor retardation Personality changes Social isolation Lacks in visual-spatial memory Difficulties in visual- motor coordination Difficulties in performing complex tasks Attention defficits Impaired verbal memory Mental slowing Loss of balance, unsteady gait Leg weakness Dropping things Tremors, decline in fine motor skills Mental health disorders More than 20% HIV positives suffer form depression High risk of suicide Anxiety disorders Difficulties in impulse control (aggressiveness) 3
4 Attitudes to HIV and AIDS Results of many studies show that most of people despite of they declarations, in reality avoid HIV infected persons Although more and more Poles declare readiness to take care after relatives with AIDS (56%), in practice many of them are afraid of HIV positives and tend to avoid the contact with them In % of Poles presented discriminatory attitudes towards HIV infected persons. Contact with HIV-infected persons can be challenging It depends on beliefs on AIDS and HIV, where moral or ethical values may be involved It is result of pervious experiences It is influenced by expectations and attitudes of ill persons 4
5 Sources of risk: Being stuck, accidentally or intentionally, by an infected needle First medical aid without protection Sexual intercourse with accidental partner Risk behaviors in drug addiction What are the officers the most afraid of? Being stuck by needle (97%) Being bitten (96%) Performing first medical aid (90%) Being split (82%) Iintervention against aggressive person (70%) Search of a suspected person (69%) Arrest (54%) Handcuff (51%) Transportation of arrested persons (42%) Being in the same room with HIV-infected person (36%) Public Health Reports vol
6 Emotional reactions to risk of infection: Shock Fear and anxiety Depression Anger and frustration Guilt Real or probable risk of HIV infection Immediate stress reaction Natural healing Acute Stress Disorder Posttraumatic Stress Disorder 6
7 CRISIS Emotional adaptation RAGE PAIN/ TORMENT ADAPTATION TIME COLLAPSE SYMPTOMS OF EMOTIONAL SHOCK: Re-experiencing of the trauma (recurrent, intrusive recollections of the event, permanent intrusive thoughts etc); Avoidance of thoughts, feelings, places, people and situation associated with events; Symptoms of increased arousal; Touch of death 7
8 Immediate stress reaction (during exposition to threat) 1. Cognitive and emotional reactions (perception and interpretation of the event) 2. Observable behaviors 3. Defense mechanisms Ordinary stress reaction. 1. Intensive intrusions (thoughts, images, bodily sensations) 2. Denial, not believing in anything has happened 3. Numbing 4. Derealisation 5. Increased arousal (not present before) 8
9 Cognitive proceses and PTSD development (Foa, Rothbaum, 1998) Cognitive schemata: Extreme,inflexible Traumatic event After traumatic event Picture of trauma: That s my fault, I I am not able to cope with.. PATOLOGY WORLD is dangerous Picture of events after trauma: I can t trust anybody I am getting crazy Cognitive processes and healing (Foa, Rothbaum, 1998) SCHEMATY POZNAWCZE: Traumatic event balanced, realistic After traumatic event Picture of trauma: It s happened, I have accept the reality I I am competent enough to cope with healing WORLD is safe, in general Picture of events after trauma: Sometimes, people are bad My reactions are adequate to the situation 9
10 Worried well syndrome Multiple physical complaints which person interprets as sure evidence of their HIV infection Repeated negative HIV tests Anxiety and depression Occupational risk of HIV infection Could be a stressor for officers and their families Family members or friend could be afraid of being in contact with severe disease Occupational risk is very low, but cannot be ignored 10
11 Coping in high risk situation Make tests Keep in mind the knowledge on HIV and AIDS If you feel overwhelming by emotions think about: - taking some free of work days - stronger involvement in tasks which need full attention - psychological counseling. Be gentle for yourself in time of waiting for tests results 11
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