People may live with HIV for many years after diagnosis with little or no noticeable change in their health. However, sooner or later it will be necessary to start antiretroviral (ARV) treatment in order to slow the progression of the disease. This can be a very challenging time as the realisation that ARV drugs will have to be taken daily for life is a stark reminder of being infected with a chronic disease. Any antiretroviral drug side effects from the treatment will also serve to bring home the reality of HIV.
For antiretroviral therapy to be most effective, patients must adhere well to the regimen, meaning they must take their medicine at the prescribed time at least 95% of the time. Such a high degree of commitment means that someone should be in a fit mental state before beginning HIV treatment. It has been shown that of people with HIV who had depression, those who took antidepressants adhered better to antiretroviral therapy. Furthermore, adherence rates among those taking depression medication were similar to those without depression.14 Results such as this underline both the need for depression to be both diagnosed and then treated as a means of positively affecting HIV treatment.
My CD4 was in double digits and I found out that I was resistant to all of the medication I had been taking. I couldn't beleive what I was hearing and ANGRY is putting it mildly as to how I was feeling at that moment, as well as betrayed. I wanted to sue everyone involved and make them pay for their inability to treat me properly.”Mark
Needing to switch treatment if it is established that the original drug regimen is failing to work or is not tolerable can also be distressing. It may be upsetting to know that some treatments do not work effectively and that switching drugs, for perhaps not the first time, is one more step in exhausting all available options. People may also recall bad experiences from previous drug regimens and be anxious about what the new drugs may bring. Adjusting to a new treatment regimen may be mentally draining if dosage, frequency and time of administration differs from the one the person became accustomed to.
For people not able to access HIV treatment, they have to live with HIV knowing they cannot take the most effective action against the disease’s progression.
Tuesday, December 22, 2009
Monday, December 14, 2009
The global AIDS epidemic
Around 2.7 million people became infected with HIV in 2008. Sub-Saharan Africa has been hardest hit by the epidemic; in 2008 over two-thirds of AIDS deaths were in this region.
The epidemic has had a devastating impact on societies, economies and infrastructures. In countries most severely affected, life expectancy has been reduced by as much as 20 years. Young adults in their productive years are the most at-risk population, so many countries have faced a slow-down in economic growth and an increase in household poverty. In Asia, HIV/AIDS causes a greater loss of productivity than any other disease. An adult’s most productive years are also their most reproductive and so many of the age group who have died from AIDS have left children behind. In sub-Saharan Africa the AIDS epidemic has orphaned nearly 12 million children.
In recent years, the response to the epidemic has been intensified; in the past ten years in low- and middle-income countries there has been a 6-fold increase in spending for HIV and AIDS. The number of people on antiretroviral treatment has increased, the annual number of AIDS deaths has declined, and the global percentage of people infected with HIV has stabilised.
However, recent achievements should not lead to complacent attitudes. In all parts of the world, people living with HIV still face AIDS-related stigma and discrimination, and many people still cannot access sufficient HIV treatment and care. In America and some countries of Western and Central and Eastern Europe, infection rates are rising, indicating that HIV prevention is just as important now as it ever has been. Prevention efforts that have proved to be effective need to be scaled-up and treatment targets reached. Commitments from national governments right down to the community level need to be intensified and subsequently met, so that one day the world might see an end to the global AIDS epidemic.
The epidemic has had a devastating impact on societies, economies and infrastructures. In countries most severely affected, life expectancy has been reduced by as much as 20 years. Young adults in their productive years are the most at-risk population, so many countries have faced a slow-down in economic growth and an increase in household poverty. In Asia, HIV/AIDS causes a greater loss of productivity than any other disease. An adult’s most productive years are also their most reproductive and so many of the age group who have died from AIDS have left children behind. In sub-Saharan Africa the AIDS epidemic has orphaned nearly 12 million children.
In recent years, the response to the epidemic has been intensified; in the past ten years in low- and middle-income countries there has been a 6-fold increase in spending for HIV and AIDS. The number of people on antiretroviral treatment has increased, the annual number of AIDS deaths has declined, and the global percentage of people infected with HIV has stabilised.
However, recent achievements should not lead to complacent attitudes. In all parts of the world, people living with HIV still face AIDS-related stigma and discrimination, and many people still cannot access sufficient HIV treatment and care. In America and some countries of Western and Central and Eastern Europe, infection rates are rising, indicating that HIV prevention is just as important now as it ever has been. Prevention efforts that have proved to be effective need to be scaled-up and treatment targets reached. Commitments from national governments right down to the community level need to be intensified and subsequently met, so that one day the world might see an end to the global AIDS epidemic.
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