Журнал инфектологии (Dec 2019)
Psychological problems of HIV-infected patients in preparing to the start of antiretroviral therapy
Abstract
Objectives: to find out and. analyze the problems of HIV-infected. patients which require additional attention of specialists during counseling before the start of antiretroviral therapy as well as to assess patients' needs in psychological help.Materials and methods: the data are collected, by the questionnaire and. psychometrical screening using The Somatic Symptom. Disorder — B Criteria Scale from 365 HIV-infected. patients, including 155 (42,5%) females who took part in the group psychological counseling for preparing to the start of antiretroviral therapy from July 2017 to July 2018. The average age was 37.2 years old.Results: the difficulties due to HIV-infection, which, are mentioned, by patients before the therapy start, are ranged, by the frequency of their answers as follows: 1) ««need, to conceal HIV diagnosis» — 27,1% answers, 2) ««lack of time for visiting the doctor» — 26,6%; 3) ««depression and/or anxiety» — 26,0%; 4) ««need, to use condom» — 19,5%; 5) ««restrictions in employment» — 10,1%; 6) ««disclosure of HIV diagnosis to the partner» — 8,5%. Less common are ««difficulties to interact with the doctor» (4,4%), ««impossibility to work in the specialty» (4,4%) and. ««the rejection from significant others» (4,1%). The monitoring of HIV treatment adherence showed, that 31,8% of patients were not ready to start taking medications right after the doctor's recommendations, and. 13,4% postpone the start of treatment for more than half a year.Conclusion: in preparation for the start of antiretroviral therapy a patient needs the assistance in time scheduling required. for treatment. The discussion, with patients about their attitudes towards condom use and their self-efficacy to use condom, helps patients to overcome their fear of HIV diagnosis disclosure and. therefore reduces their risky sexual behavior. Psychological screening helps revealing psychological tension and allows offering the consultation of psychiatrist or psychologist with the purpose to correct mental state as well as to facilitate patient's efforts to develop adherence to continual treatment.
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