People with AIDS: these are their special needs

This syndrome not only generates medical symptoms; it also produces psychological vulnerabilities.

Acquired Immune Deficiency Syndrome, or AIDS, is one of the biggest pandemics in the world today. pandemics that exist today, and it is still an incurable disease of great severity. The suffering of AIDS is a hard blow for those who suffer from it, being a very serious condition in which any infection can become complicated to dangerous levels and, without treatment, even fatal.

In the absence of a curative treatment, the prevention of this disease is fundamental, and there is a large amount of information available on both AIDS and the human immunodeficiency virus infection (which causes it).

But despite major prevention campaigns, many people do not know exactly what it is or understand the emotional suffering of those who suffer from it. What is the disease and how do people with AIDS live with it? How can the disease be treated? We will talk about it along the following lines.

Acquired Immunodeficiency Syndrome symptoms

It receives the name of Acquired Immunodeficiency Syndrome or AIDS to the last phase of the infection by the virus of the human immunodeficiency or HIV, being a syndrome of great gravity that appears when the immune system has been practically destroyed and is no longer able to cope with infections. Specifically, sufferers have a number of T-lymphocytes (especially CD4+) below 200 per cubic millimeter of blood, which is insufficient to protect the body from opportunistic infections or certain cancers (some of which increase the likelihood of occurrence).

Although HIV infection itself may not cause any symptoms, if the infection leads to AIDS, there is often a sudden and rapid weight loss, fatigue on the slightest effort, headaches, fevers, edema in the lymph nodes, diarrhea that may continue for a month, kaposi sarcomas (vascular tumors in the form of spots and red lesions that in fact in many cases may be one of the clearest signs of AIDS).

All of this is due to the involvement of the virusas well as the loss of the immune system's ability to protect itself. In addition, there may be symptoms of opportunistic infections that may occur, such as tuberculosis (the main cause of death of infected patients in African countries).

Neurological or nervous disorders, such as motor slowing, tingling or loss of muscle tone, are also common. In some cases cognitive impairment and emotional and behavioral problems also appear.Sometimes it can even lead to a rapid dementia in which the patient loses faculties rapidly until his death a few months later.

All this without taking into account the profound emotional impact of receiving the diagnosis, which often generates panic and anxiety and can easily lead to depression. The person with AIDS may have a constant feeling of being threatened and in danger.The patient may have a feeling of lack of control over the situation, hopelessness, feelings of guilt and fear of their future. In some cases, suicidal ideation and attempts may even appear.

In addition to this, it is necessary to face a potentially life-threatening situation that will generate the need to will generate the need to change the habits of life, such as taking medicationsuch as taking medication or other self-management strategies. Finally, it can also lead to the loss of a partner, job or even travel restrictions.

It is important to keep in mind that, fortunately, AIDS is a syndrome that does not necessarily appear in those who become infected with HIV, since the existing treatments, although they do not cure the disease, do not cure it. existing treatments, although they do not cure the infection, do make it possible to control it.. However, in the absence of adequate treatment, most people will develop it.

Also, when there is no treatment (especially in those countries with a poor health system, such as in poor areas of Africa) AIDS can cause death a few years after its appearance, making it a problem that is still very serious and causes the death of millions of people even today (although it is not so common in Western society).

How do people with AIDS come to suffer from it? Contagion

AIDS is, as we have said, a syndrome that occurs in the final and most severe stages of HIV infection, the latter being the cause of Acquired Immunodeficiency Syndrome. This infection infection reaches the human organism through contact between infected mucous membranes and fluids, mainly Blood and sexual fluids.mainly blood and sexual fluids. Breast milk may also cause transmission of the virus. Other fluids such as saliva, feces, mucus, vomit or urine have a very limited or non-existent viral load.

Thus, infection generally comes through unprotected sexual intercourse in which mucous membranes come into contact or through the shared use of syringes in drug addicts, or razor blades. In the past it was spread through blood transfusions, although this is now unlikely.

It could also be transmitted from mother to child in the case of pregnant women, during childbirth or at the time of delivery.It can also be transmitted from mother to child during childbirth or breastfeeding. However, casual contact, hugging, kissing, sharing cutlery or glasses, using the same toilet or bathing in the same swimming pool are not methods of contagion.

It is important to keep in mind that it is the HIV virus that is transmitted, not AIDS itself.. After infection, the situation will progressively worsen, with the virus spreading throughout the body and increasing the viral load while destroying the lymphocytes and the immune system.

Among other things, there is a decrease in lymphoid cells (which generate lymphocytes), for example in the gastrointestinal tract. Initially, there are usually no symptoms, but in the long term, if AIDS develops, the above-mentioned problems may appear.

Treatment of this disease

AIDS is a serious condition that without treatment can cause death within a few years.. But although it is still a very serious condition in areas with a sufficiently high level of health care, there are treatments that make the survival rate even when HIV leads to AIDS much higher, not being a death sentence as in the past (although it is still a serious disease).

The first of the treatments to be taken into account is the pharmacological one, being, as in other phases of the infection, the taking of antiretroviral drugs necessary to maintain the remains of the immune system, slightly increasing the levels of lymphocytes and decreasing the viral load while decreasing the possibility of suffering other infections, improving both life expectancy and the quality of life. For this purpose, a treatment that includes multiple antiretroviral drugs is used treatment including multiple antiretrovirals, such as zidovudine or tenofovir, is used..

However, it is likely that this treatment may cause immune reconstitution inflammatory syndrome, an inflammatory type of alteration that does not, however, prevent treatment from continuing.

Since in AIDS the immune system has already lost most of its ability to defend itself, regular check-ups (every six months to a year) and preventive measures are essential. preventive measures to avoid as much as possible the arrival of opportunistic infections, as well as to control the possible appearance of tumors (more frequent and dangerous when AIDS is present). In addition, measures should be taken to prevent possible bone, liver and kidney damage, and to control and promote nutrition and the avoidance of drugs and alcohol.

Psychological care for people with AIDS

People with AIDS are suffering from one of the most feared diseases worldwide, something that undoubtedly, as we have already mentioned, can generate a series of serious emotional and cognitive complications that can even worsen their state of health. In this sense, those affected by this disease may require psychological treatment..

The first thing to take into account in these cases is that the subject is facing a very distressing situation, requiring emotional containment and the possibility of expressing their fears, doubts and thoughts in an environment where they do not feel judged and that generates sufficient confidence. They will also need, especially in the case of an unexpected diagnosis (e.g. a case where they did not know they were infected until that moment), psychoeducational guidelines to understand what is happening to them and what preventive measures they should take.

It is essential to work on adherence to antiretroviral treatment, as well as, as far as possible, the prevention of substance abuse and risky practices.

It is not uncommon for some people with HIV or AIDS to think that because they already have the infection they can have unprotected relations with other people with the same disease, but the truth is that given that there are a great variety of HIV strains, this could generate superinfections that are much more dangerous and difficult to treat. Psychoeducation is not only necessary for the patient him/herself, but may also be essential for the patient.It may also be essential for the patient's partner and/or his or her close environment.

Another aspect to highlight is the need to work on the significance of AIDS for the patient, how the person experiences his or her state of health, the meaning he or she gives it and how he or she feels about it.

In addition, it will also be necessary to work on the possible existence of vital barriers that the subject has erected, limiting, for example, his social life out of fear or isolating himself due to feelings of guilt or rejection.. In this sense, it is worth assessing what kind of barriers have been generated, why and what effects they have on his life, in order to subsequently rethink the need for a change to break down these barriers and facilitate his day-to-day life.

Another important element to work on is the lack of perception of control, as well as sociability. Problem solving and social skills training can be fundamental, as well as the scheduling of pleasant activities.

Values work and cognitive restructuring of maladaptive beliefs and AIDS myths are also helpful, especially in those with anxious or depressive problems. (especially in those who are at risk of suicide). Another measure that can help them greatly is to go to mutual help groups or associations of people affected by the disease, since they make it easier to feel understood and to share their experiences, as well as to learn different ways of acting or living with the disease.

Bibliographic references:

• Avelar, V.Y.; Cornejo, I.B. and Torres, J.D. (2011). Psychological effects in people of both sexes between the ages of 20 and 50 years diagnosed with HIV in the period from January 2006 to June 2010 belonging to the Salvadoran foundation for the fight against AIDS "Maria Lorena" (CONTRASIDA) of the municipality of San Salvador. University of El Salvador. Faculty of Sciences and Humanities. Department of Psychology.
• Gulick, RM. (2016). Antiretroviral therapy of human immunodeficiency virus and acquired immunodeficiency. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 388.
• Vyas, J.M.; Zieve,D.; Conaway, B. et al. (2017). VIH/SIDA. MedlinePlus [Online]. Disponible en: https://medlineplus.gov/spanish/ency/article/000594.htm.