The psychological and social impacts of HIV/AIDS can be significant. People living with HIV/AIDS may experience fear, anxiety, depression, social isolation, and stigmatization. They can face challenges in relationships, employment, and perceptions from others. Children with HIV/AIDS may have to cope with a lack of a normal childhood, fears of dying, and changes in parental relationships. Overall, living with a chronic illness like HIV/AIDS takes a psychological and social toll on many people's well-being and quality of life.

1. Elchin Hasanli Muhammed Merzah

2.  WHAT IS HIV/AIDS?
 ORIGIN OF HIV/AIDS
 DISCOVERY OF HIV/AIDS
 HIV/AIDS INCIDENCE
 SYMPTOMS OF HIV/AIDS
 HIV/AIDS PREVENTION
 THE PSYCHOLOGICAL AND SOCIAL IMPACTS ON
PEOPLE WITH HIV/AIDS
 TREATMENT OF HIV/AIDS
 CONSENT TO HIV TEST AND TREATMENT
 CONFIDENTIALITY

3.  “HIV” stands for Human Immunodeficiency Virus
 H – Human – This particular virus can only infect human beings
 I – Immunodeficiency – HIV weakens your immune system by
destroying important cells that fight disease and infection. A
"deficient" immune system can't protect you.
 V – Virus – A virus can only reproduce itself by taking over a cell in the
body of its host.

5.  “AIDS” stands for Acquired Immunodeficiency Syndrome
 A – Acquired – AIDS is not something you inherit from your parents.
You acquire AIDS after birth.
 I – Immuno – Your body's immune system includes all the organs and
cells that work to fight off infection or disease.
 D – Deficiency – You get AIDS when your immune system is "deficient,"
or isn't working the way it should.
 S – Syndrome – A syndrome is a collection of symptoms and signs of
disease. AIDS is a syndrome, rather than a single disease, because it is
a complex illness with a wide range of complications and symptoms.

6.  HIV is a member of the genus
Lentivirus , part of the family
Retroviridae
 It is single –stranded , positive-
sense , enveloped RNA viruses
 It is spherical with diameter of
about 120 nm , around 60 times
smaller than a red blood cell

7. Scientists believe HIV came from a
particular kind of chimpanzee in
Western Africa. Humans probably
came in contact with HIV when they
hunted and ate infected animals.
Recent studies indicate that HIV
may have jumped from monkeys to
humans as far back as the late
1800s.

8.  AIDS was first clinically observed
in 1981 in the United States.
 Three years later, in 1984, Luc
Montagnier of the Pasteur
Institute of Paris and Robert
Gallo then of the National Cancer
Institute announced their
discovery of HIV, the virus that
infects the human immune
system and causes AIDS.

9. HIV incidence is the number of new HIV infections in a population during
a certain time period. The determination of HIV incidence in a population
is important to:
 monitor the epidemic
 improve the targeting of populations for interventions
 to evaluate the effectiveness of HIV prevention and treatment
programs.
This is especially important in low and middle income countries that
continue to bear a disproportionate share of the global burden of
HIV/AIDS. In addition, the identification of newly infected persons will
allow for interventions to reduce the risk of HIV transmission.

10.  More than 35 million people are now living with HIV.
 3.2 million are under the age of 15.
 In 2013, an estimated 2.1 million people were newly infected with HIV.
 240,000 were under the age of 15.
 Every day more than 5,700 people contract HIV—nearly 240 every hour.
 In 2013, 1.5 million people died from AIDS.
 Since the beginning of the pandemic, nearly 78 million people have
contracted HIV and close to 39 million have died of AIDS-related causes.
 In 2013, around 12.9 million people living with HIV (37% of the total) had
access to antiretroviral therapy.

12. HIV may not cause symptoms early on. People who do have symptoms
may mistake them for the flu or mono. Early symptoms of HIV are called acute
retroviral syndrome. The symptoms may include:
 Belly cramps, nausea, or vomiting.
 Diarrhea.
 Enlarged lymph nodes in the neck, armpits, and groin.
 Fever.
 Headache.
 Muscle aches and joint pain.
 Skin rash.
 Sore throat.
 Weight loss.

14.  Pain when swallowing
 Confusion, trouble concentrating, or
personality changes.
 Repeated outbreaks of cold
sores or genital herpes sores.
 Tingling, numbness, and weakness in the
limbs.
 Mouth sores or a yeast infection of
the mouth (thrush).
 Diarrhea or other bowel changes.
 Fatigue.
 Fever.
 Loss of appetite or
unexplained weight loss.
 Dry cough or shortness of breath.
 Nail changes.
 Night sweats.
 Swollen lymph nodes in the neck,
armpits, and groin.
LATER SYMPTOMS MAY INCLUDE:

16. Symptoms in women and children
 HIV may be suspected when a woman has at least one of the
following:
 More than 3 vaginal yeast infections in 1 year that aren't related to the
use of antibiotics
 Recurrent pelvic inflammatory disease (PID)
 Abnormal Pap test or cervical cancer
 Children who have HIV often have different symptoms (for example,
delayed growth or an enlarged spleen) than teens or adults.

17. Safer sex
 Practice safer sex. This includes using a condom unless you are in a
relationship with one partner who does not have HIV or other sex partners.
 If you do have sex with someone who has HIV, it is important to practice
safer sex and to be regularly tested for HIV.
 Talk with your sex partner or partners about their sexual history as well as
your own sexual history. Find out whether your partner has a history of
behaviors that increase his or her risk for HIV.
 You may be able to take a combination medicine every day to help prevent
infection with HIV. This medicine can lower the risk of getting HIV. But the
medicine is expensive, and you still need to practice safer sex to keep your
risk low.

18. Alcohol and drugs
 If you use alcohol or drugs, be very careful. Being under the influence
can make you careless about practicing safer sex.
 And never share intravenous needles, syringes, cookers, cotton ,
cocaine spoons, or eyedroppers with others if you use drugs.

19. If you already have HIV
 If you are infected with HIV, you can greatly lower the risk of spreading
the infection to your sex partner by starting treatment when your
immune system is still healthy.
 Experts recommend starting treatment as soon as you know you are
infected.
 Studies have shown that early treatment greatly lowers the risk of
spreading HIV to an uninfected partner

20. Steps to avoid spreading HIV
 If you are HIV-positive (infected with HIV) or have engaged in sex or
needle-sharing with someone who could be infected with HIV, take
precautions to avoid spreading the infection to others.
 Tell your sex partner or partners about your behavior and whether you
are HIV-positive.
 Follow safer sex practices, such as using condoms.
 Do not donate blood, plasma, semen, body organs, or body tissues.
 Do not share personal items, such as toothbrushes, razors, or sex toys,
that may be contaminated with blood, semen, or vaginal fluids

21. If you are pregnant
 The risk of a woman spreading HIV to her baby can be greatly reduced
if she:
 Is on medicine that reduces the amount of virus in her blood to
undetectable levels during pregnancy.
 Continues treatment during pregnancy.
 Does not breast-feed her baby.
 The baby should also receive treatment after it is born.

22.  “The psychological challenges a person with
HIV/AIDS faces vary from individual to individual.
Not everyone will experience all of the
emotional responses. Each HIV/AIDS situation is
as unique as the people involved. There are
individuals who might face catastrophic changes
not only in their personal and job relationships,
but in their physical bodies and in their self-
images and self-esteem”.( Watstein and
Chandler, 1998) As a result of these changes in
both working and personal relationships, the
behaviour of those infected may change. They
may become withdrawn, aggressive, and rude to
colleagues and friends. Infected persons are
normally in fear because they have to adjust to a
new lifestyle
The Psychological and social Impact on
people with HIV/AIDS

23. Children are also infected with the
virus as a result of prenatal
transmission or through sexual
abuse. These children experience
almost a complete loss of childhood
since they are continuously sick and
cannot engage in the normal
childhood activities. Other children
are also warned by their parents not
to play with the infected ones for
fear of contracting the disease. For
an infected child, the fear of dying is
constantly prevalent. This impairs
normal emotional and psychological
functioning.

24.  A parent who is HIV infected may show less interest in the child due to
the dramatic mood swings associated with the pressure of being
infected. The child usually does not know what the problem is, that it
is not his or her fault, and does not understand why the parent seems
moody. The child is likely to react with fear and anxiety and sometimes
will blame themselves. Children tend to worry all the time and are also
afraid that one day they will find their parents dead when they come
home from school. They also worry about who is going to take care of
them.

25.  -Relationships: One important social effect of HIV and AIDS is relationships. When someone is
carrying the disease it can be difficult for them to start new relationships and, in some cases, maintain
existing ones. Having the disease means they cannot have intercourse with anyone else unless they wear
protection
 -Casual Contact: Many people who live with AIDS or HIV also have to live with the stigma of how other
people may treat them. This may stem from certain individuals not being completely educated on the
basics of the disease or the virus. Many people avoid people known to be infected with the illness out of
fear that they may contact the disease
 .Employment: Some people who disclose to their future or present employer that they are HIV positive or
carry the AIDS virus may be discriminated against. They may be told they will not be hired or they will be
let go for a reason that can not be supported or backed up. However, like people in America with HIV or
AIDS are protected under the Americans with Disabilities Act. If someone who feels they have been
discriminated against, they will contact the ADA or the Job Accommodation Network to seek help and
assistance with their specific matter. The only way an employer could choose not to hire them legally is if
they feel they may be a clear risk to others like job involves direct patient contact care such as
phlebotomy, surgery or dialysis.

26. Treating HIV
There is no cure for HIV, but there are treatments to enable
most people with the virus to prolong a healthy and active
lifestyle.
If someone is diagnosed with HIV, they will have regular blood tests to
monitor the progress of the HIV infection before starting treatment.
This involves monitoring the amount of virus in the blood and the effect
HIV is having on the immune system. This is determined by measuring
the levels of CD4+ve lymphocyte cells in the blood. HIV is treated with
antiretrovirals (ARVs), these work by stopping the virus replicating in
the body, allowing the immune system to repair itself and preventing
further damage. A combination of ARVs is used because HIV can quickly
adapt and become resistant to one single ARV. Patients tend to take
three or more types of ARV medication. This is known as combination
therapy or antiretroviral therapy (ART).Some antiretroviral drugs have
been combined into one pill. Different combinations of ARVs work for
different people. Once HIV treatment is started, they will probably
need to take the medication for the rest of their life.

28.  There a lot of reasons why people are might be reluctant to have a test
or treatment for HIV.
 In clinical studies, people refusing to have antiretroviral treatment (ART) have cited various factors:
quality of life, side-effects, the risk of developing resistance to the drugs, believing they do not need ART
or having a preference for complementary and alternative medicine.
 Under common law, a competent adult has the right to refuse medical testing or treatment for any
reason or for no reason at all. Obtained informed consent for any test or treatment is fundamental
principle of medical ethics and good practice. General Medical Council advices doctors to discuss
treatment options in understandable terms and to respect the individual’s right to make choices about
their care.

29. When carrying out tests or giving treatment, in order to act
legally the doctor must ensure one of three conditions are met:
 ▪The patient has given consent or
 ▪Another person authorised to act as the patient’s representative has given consent (for
example, a child’s parent)or
 ▪Treatment that is in the best interests of the person is urgently needed, without time to
obtain consent.
 Consent for medical tests and treatment must be:
 ▪Granted by an adult or young person who has the mental capacity to make such a decision.
 ▪Voluntary and not given under pressure
 .▪Based on an understanding of the potential risks and benefits.

30.  In some cases, clinicians may think that a person needs a medical test or
treatment, but the individual may not able to make the decision for themselves.
 If the incapacity is temporary, tests or treatment should be postponed until the
individual is once again able to decide for themselves.
 If the condition is permanent and another individual has been granted power of attorney for
the person’s health and welfare, they can make the decision.
 Clinicians may however ask next of kin about the patient’s likely preferences and wishes, so
that they may understand what would be in their best interests.

31. Health professionals may face a dilemma
if a pregnant woman decides against
testing or treatment for HIV. While these
interventions may have significant
benefits for the child, the mother has
every right to refuse them during
pregnancy. Pregnant women are
encouraged to have an HIV test because
treatment are very effective in
preventing transmission from mother to
child. Some countries like England and
Wales offer HIV test to pregnant women
as part of their antenatal care and the
majority agree to have it.
If the medical team have a reason to believe that the foetus
may be at risk of HIV infection, they should continue to offer
the test throughout pregnancy and attempt to address any
fears the woman may have about accepting it. If an HIV-
positive mother cannot be persuaded to accept any
intervention to reduce the risk of mother-to-child
transmission, clinical guidelines encourage the medical team
to pursue the matter as a child protection issue so that the
baby may be tested and treated at birth.
Pregnant women

32.  Parental responsibility includes giving consent to medical treatment on behalf of the child. In addition,
children have human rights such as the right to life and the best possible health, and parents have the right to
respect for private and family life. These rights may come into conflict when clinicians believe that a child
should be tested or treated for HIV and a parent disagrees.
 Some HIV(+ve) parents remain reluctant to agree to testing for their child. Reasons might include:
 ▪They do not feel that the child has been at risk.
 ▪Fear of disclosure – a diagnosis of HIV could have social and family implications, for example if the virus was
passed on by a parent
 .▪Feelings of guilt
 .▪Psychological denial - an inability to accept or cope with the risk of HIV or a diagnosis in the parent and
potentially the child.
 ▪Fear of stigmatising the child and the family.
 If healthcare professionals believe a child is at risk of HIV infection, they should make every effort to persuade
the parents to agree to a test.

33.  All healthcare professionals are obliged by law, to ensure everyone medical information remains
confidential. Someone medical records should not be seen by anyone who is not involved in their
treatment and care, unless they give them permission to do so.
 Sharing information between healthcare professionals:
 Communication between healthcare professionals is likely to improve the quality of care. For example, if
GP and someone’s HIV doctor are able to share information about patient’s health and any treatment,
patient’s understanding of their overall health will be better. This shouldn’t mean chatting about them in
corridors or public areas, or gossiping about them. The exchange of information should be limited to what
is needed to ensure that they receive the best possible care. Any doctor they see should keep them
informed about anyone they intend to share their medical information with. Communication between
healthcare professionals will usually be in writing and patients should always receive a copy of the letter or
email.

34.  . Doctors including GPs and specialists could be obliged to disclose patient’s HIV status under certain
circumstances. However, disclosure without their knowledge and consent is very rare; whenever
possible, they will be notified first. If their doctor believed they were placing another person at risk of
‘serious harm’ because of their HIV status, and they refused to disclose their status to that person, their
doctor could inform them. ‘Serious harm’ can include the significant risk of passing on a serious
communicable disease, such as HIV. They should consult the patient before doing this, but if they don’t
give their consent at this point, they may still be entitled to pass on the information. They would avoid
disclosing their identity if possible. This situation happens very rarely. In some cases, a doctor may
disclose information from patient’s medical records, if you request them to.
 To an insurance company. If someone apply for certain types of insurance such as health or life insurance,
and permit the insurer to access information from their medical records, their doctor will be obliged to
share this information; their HIV status may affect your application.
 To an employer. An employer may ask for information about someone health and their medical history; for
example, if an occupational health assessment, or pre-employment questionnaire, is part of their
recruitment process. They do not have to consent to this; however, it may affect their employment if they
decide not to.

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