Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0019693 (HIV)
 170,526 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The HIV/AIDS epidemic is compared to the World War II-era Holocaust during which millions of people were persecuted. Those infected and affected by HIV/AIDS are described as undergoing a form of post-traumatic stress disorder. People who provide physical, social, and mental health care services to HIV/AIDS clients are reminded to facilitate the participation in the emotional healing process and to allow time and space for grieving. Individuals and communities need rituals as a vehicle for the expression of their grief. Providers must keep issues of abandonment, respect, compassion, and living with uncertainty in the forefront. Individual successes in the lives of HIV/AIDS patients, such as return to work or school, should be acknowledged and celebrated.
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PMID:Back to the future: survival, uncertainty, and hope. 1136 42

An estimated 30% to 50% of cocaine-dependent individuals meet criteria for lifetime PTSD. This comorbidity has detrimental effects on clinical presentation, and treatment course and outcome. Cocaine dependence is associated with increased rates of exposure to trauma, more severe symptoms, higher rates of treatment attrition and retraumatization, and greater vulnerability to PTSD when compared to other substance use disorders. These associations underscore the need for effective treatments that address issues particular to PTSD in a manner tolerable to cocaine-dependent individuals. This article describes a manualized psychotherapy developed specifically for individuals with PTSD and cocaine dependence. Concurrent Treatment of PTSD and Cocaine Dependence (CTPCD) provides coping skills training, cognitive restructuring techniques, and relapse prevention strategies to reduce cocaine use. In-vivo and imaginal exposure therapy techniques are incorporated to reduce PTSD symptom severity. Primary treatment goals include psychoeducation specific to the interrelationship between PTSD and cocaine dependence, and clinically meaningful reductions in cocaine use and PTSD symptomatology. Secondary goals include a reduction in HIV high-risk behaviors and improved functioning in associated areas, such as anger and negative affect management.
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PMID:Exposure therapy in the treatment of PTSD among cocaine-dependent individuals: description of procedures. 1151 25

We present this medical-psychiatric case discussion to illustrate the psychodynamic aspects of nonadherence in a woman with AIDS. Our patient sustained severe, repeated abandonment and brutal emotional, physical and sexual trauma throughout her early and later childhood and adult life. Her care was considerably complicated by the sequelae of trauma including difficulty with trust and posttraumatic stress disorder. The additional problem of HIV dementia compounded the patient's nonadherence to treatment. We present a multidisciplinary biopsychosocial approach that enabled the patient to engage in both medical and psychiatric care.
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PMID:Understanding the psychodynamics of non-adherence to medical treatment in persons with HIV infection. 1206 43

Commercial sex work presents specific mental health concerns. We aimed to study motivation for sex work and mental health issues in a sample of such women. We contacted 55 consenting women through organized brothels and interviewed them using the Farley questionnaire and screening items for posttraumatic stress disorder (PTSD) and depression. Eighty-two percent of the women had arrived illegally and had been "trafficked." All but 2 were engaged voluntarily in sex work. Seventeen percent met criteria for PTSD, and 19% were likely to be clinically depressed. We present representative case histories. Availability of mental health treatment for workers in the sex industry could improve compliance with HIV prevention programs and enlarge options for women to leave the sex industry. We observed that stereotypes of sex workers as either always having histories of childhood abuse or as being always "happy hookers" were incorrect.
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PMID:The motivation and mental health of sex workers. 1208 69

Studies describing posttraumatic stress disorder (PTSD) as a result of physical illness and its treatment were reviewed. PTSD was described in studies investigating myocardial infarction (MI), cardiac surgery, haemorrhage and stroke, childbirth, miscarriage, abortion and gynaecological procedures, intensive care treatment, human immunodeficiency virus (HIV) infection, awareness under anaesthesia, and in a group of miscellaneous conditions. Cancer medicine was not included as it had been the subject of a recent review in this journal. Studies were reviewed in terms of the prevalence rates for PTSD, intrusive and avoidance symptoms, predictive and associated factors and the consequences of PTSD on healthcare utilization and outcome. There was considerable variability both in the study methodology and design and in the results. The highest prevalence rates were identified in patients treated in intensive care units (ICUs) and those with HIV infection. Irrespective of the physical illness, posttraumatic symptomatology is more common than PTSD caseness. Existing characteristics of the patient may well predispose individuals to the development of PTSD as do other factors such as poor social support and negative interactions with healthcare staff. Generally, the severity of the illness itself is not predictive of PTSD. Issues relating to sampling, attrition, diagnosis, the course of symptoms, aetiological pathways, and the consequences of the disorder are discussed. The presence of PTSD most probably influences the patient's use of healthcare resources and may affect their clinical outcome.
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PMID:Posttraumatic stress disorder following medical illness and treatment. 1272 79

This study examined the relationship between pre-migration trauma and HIV-risk behavior in refugees from sub-Saharan Africa. The sample comprised 122 persons who had emigrated from sub-Saharan Africa and were currently residing in Sweden. Qualitative methods including individual interviews, focus groups, and interviews with key informants addressed questions regarding trauma experience and HIV-risk behavior. A history of pre-migration trauma was found to be associated with HIV-risk behavior. According to the participants, symptoms associated with post-traumatic stress disorder, depression, adjustment disorder, and substance use mediated the relationship between pre-migration trauma and sexual risk behavior. In contrast, a minority of the participants who reported pre-migration trauma but not psychological sequelae, or experienced post-traumatic growth, reported safer sexual practices. It appears that for some individuals, pre-migration trauma resulted in psychiatric sequelae, which may increase an individual's risk to be infected with HIV. Interventions targeted at individuals at increased risk (i.e. pre-migration trauma with unresolved psychiatric symptomatology) may facilitate the prevention of HIV and other sexually transmitted diseases in this population. Integration of multiple psychosocial and health issues is recommended for comprehensive treatment and prevention programs.
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PMID:Pre-migration trauma and HIV-risk behavior. 1276 13

The phenomenon of post-traumatic growth has been explored within the context of HIV disease in only a limited fashion. One hundred and seventy-six bereaved HIV/AIDS carers located all over Canada responded to a questionnaire about their experiences; 51.7% of these individuals were male, 46% were female and 2.3% were transgender. The range of deaths experienced was from 0 to 110. Forty-four per cent of the carers were themselves HIV-positive. Of all the HIV carers in this study, 86.4% of them exhibited symptoms of post-traumatic stress disorder. Despite this, 81.8% had scores high enough to be indicative of post-traumatic growth. This study provides a portrait of bereaved HIV carers in Canada and both the positive and negative realities associated with that situation.
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PMID:Trauma and growth in Canadian carers. 1295 19

This study explored suicidality among 190 (68% male) participants in an HIV mental health clinic. Twenty-six percent had suicidal thoughts within 30 days of admission, 49% had a plan, and 48% expressed intent stating there was moderate or high likelihood they would take action. The most prevalent diagnoses among those with suicidal ideation were major depression (64%), drug dependence (52%), and depressive personality disorder (50%). In regression analyses, individuals with major depression, dysthymia, substance abuse, thought disorder, posttraumatic stress disorder, and borderline and avoidant personality disorders were at increased risk for suicidality whereas those with narcissistic personality disorder were at decreased risk. In addition, six of seven quality-of-life variables were associated with suicidal ideation, with the strongest correlations found for leisure/social (r =.36) and family/friends (r =.33). At-risk individuals, especially those with "dual disorders," unstable interpersonal relations, and a restricted social environment, should be carefully screened for suicidality.
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PMID:Suicidal ideation among psychiatric patients with HIV: psychiatric morbidity and quality of life. 1458 95

Previous research has reported rates of posttraumatic stress disorder (PTSD) following diagnosis with a life-threatening disease ranging from 5 to 42%. However, few studies have examined the impact of PTSD symptoms on disease markers or adherence to medical regimens. The present study represents an initial examination of the relationships among self-reported PTSD symptoms stemming from diagnosis with HIV, CD4 cell counts, salivary cortisol levels and adherence to highly active antiretroviral therapy (HAART) in 110 African-American and Caucasian individuals with HIV. Results revealed that the relationship between PTSD and disease progression is multifaceted: PTSD symptoms were related to worse adherence to HAART therapy, but were also associated with lower morning salivary cortisol levels and higher CD4 cell counts.
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PMID:Posttraumatic stress disorder symptoms, salivary cortisol, medication adherence, and CD4 levels in HIV-positive individuals. 1467 29

The present study examined the frequency and correlates of self-reported symptoms of posttraumatic stress among patients with HIV and medication adherence problems. Self-report data revealed that more than half of participants met diagnostic criteria for posttraumatic stress disorder (PTSD) according to the Posttraumatic Diagnostic Scale PDS. Death anxiety was associated with overall PTSD symptom severity scores as well as severity scores for reexperiencing, avoidance, and arousal symptoms. The association between death anxiety and total PTSD severity, reexperiencing and avoidance symptom scores remained after controlling for depression and satisfaction with social support. Anxiety, as manifested by PTSD symptoms should be routinely assessed among patients with HIV, and variables such as death anxiety, social support, and depression are appropriate targets for mental health interventions.
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PMID:Symptoms of posttraumatic stress and death anxiety in persons with HIV and medication adherence difficulties. 1474 59


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