Important note: Information in this article was accurate in Winter 2002. The state of the art may have changed since the publication date.
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Research Initiative Treatment Action (RITA!); Vol 7, No. 2 Winter 2002
Individuals who learn they are infected with HIV—whether chronically or acutely—commonly experience a range of emotions including:
The psychological impact of such feelings can be profound, and referral to a counselor or therapist experienced with HIV disease is recommended. In particular, depression is the most common psychiatric disorder among HIV-infected patients and pharmacological intervention may be warranted.
Persons diagnosed with primary HIV infection (PHI) are faced with psychological challenges unique to their early disease stage. A PHI patient presenting with symptoms such as fevers, rash, or diarrhea may confuse these symptoms with those of AIDS. Patients with PHI should first be assured that they do not have AIDS and that PHI is an early disease stage after which many people remain healthy for 10 years or longer, even without treatment. Additionally, treating factors that may have contributed to infection (for instance, alcohol, drug, or sexual addiction) can help reduce further transmission, especially during such an episode of high viremia as found in PHI.
Of equal concern, especially if the clinician decides to initiate antiretroviral therapy during PHI, is that patients understand why they will be taking potent drugs to fight HIV when most chronically infected people are advised to wait until mid- or late-stage disease before starting therapy. An essential issue is whether or not patients should be enrolled into clinical study, if available. Each patient should be counseled about the pros and cons of such enrollment. Also, issues regarding potential drug side effects and toxicities, as well as the importance of adherence, should be explained.
References:
Schacker T. Primary HIV infection. Early diagnosis and treatment are critical to outcome. Postgrad Med. 1997;102(4):143-146, 149-151.
Special thanks to Miles Glaspy, LMSW-ACP, for contributing to this article.
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The Center for AIDS PHI Initiative
The Center for AIDS is currently involved in a project to identify patients with PHI who may present to hospital emergency rooms, doctors' offices, or clinics. Patients with symptomatic PHI or recent seroconversion will be referred to care, and may enroll into study through a cooperative agreement with The University of Texas Houston Health Science Center. For more information, contact:
Aga Kuliev, MD Senior Research Coordinator
University of Texas Medical School
ph: 713.873.4046 or 713.500.6703
fax: 713.873.4093 or 713.500.0610
Agadadash.Kuliev@uth.tmc.edu
or
Paul Simmons, RN
Director of Treatment Information & Advocacy
The Center for AIDS
ph: 713.527.8219 x104
fax: 713.521.3679
paul@centerforaids.org
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Copyright © 2002 - Research Initiative Treatment Action (RITA!). Reproduced with permission. RITA! is published by The Center for AIDS. Contact Thomas Gegeny, MS, ELS, Editor, RITA! for permission to reproduce RITA!. tom@centerforaids.org. http://www.centerforaids.org
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