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20 - HIV and AIDS

from Part III - Working with specific units

Published online by Cambridge University Press:  10 December 2009

By
Russell Foster  and
Ian Everall
Edited by
Geoffrey Lloyd  and
Elspeth Guthrie
Geoffrey Lloyd
Affiliation:
Priory Hospital, London
Elspeth Guthrie
Affiliation:
University of Manchester
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Summary

Introductory topics

Introduction

The psychiatric care of individuals infected with HIV encompasses a wide range of issues which, as for other chronic and life-threatening illnesses, include biological, social and psychological factors (Table 20.1). Due to the diversity of these issues, deliverance of mental health care for those with HIV infection or disease is best carried out in a multidisciplinary team setting involving co-ordination and co-operation between HIV physicians, social services, community mental health teams, child and adolescent mental health services and voluntary sector organizations as appropriate. HIV liaison psychiatry attempts to integrate the medical, psychological and social aspects of HIV and can make a unique contribution to the care and management of affected individuals (Clark & Everall 1997). In this chapter, the main aspects of HIV in the adult population and its effects on mental state are considered in terms of epidemiology, clinical manifestations and management. In addition, the impact of HIV on the mental health of two special populations – children and older adults – is considered briefly.

Epidemiology of psychiatric morbidity in those infected with HIV

Routes of transmission of HIV include sexual transmission, transmission in blood/blood products, and vertical transmission, from mother to child. In the UK the groups with the highest prevalence are homosexual men, sub-Saharan African populations (primarily due to heterosexual transmission), and intravenous drug users. Recent figures suggest that the prevalence of HIV infection in the UK is 0.11% as compared to 0.35% in Western Europe (WHO fact sheet 2000).

Keywords

AIDSantiretroviral medicationsHIVnon-nucleoside reverse transcriptase inhibitorsside-effectsnucleoside reverse transcriptase inhibitorsprotease inhibitors
Type
Chapter
Information
Handbook of Liaison Psychiatry , pp. 474 - 505
Publisher: Cambridge University Press
Print publication year: 2007

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