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NEUROPSYCHIATRIC ASPECT OF HIV INFECTION AND AIDS
HIV AND ITS TRANSMISSION
 The probability of transmission, however,could be higher, tergantung :
o
Viral load of the contact person
o
Oother factors, such as sexually transmitted diseases.The presence of sexually transmitteddiseases, such as herpes or syphilis, or other lesions that compromise the integrity of skin ormucosa, further increases the risk of transmission.
After infection with HIV, AIDS is estimated to develop in 8 to 11 years (MAKIN EARLY TREATMENT
PROGRESS MAKIN LAMA)
DIAGNOSIS AND RELATED ISSUE
1.Serum Testing
ADANYA HIV ANTIBODY
INDICATE INFECTION… NOT IMMUNITY TO INFECTION.HIV is present in blood, semen, cervical and vaginal secretions, and, to a lesser extent, insaliva, tears, breast milk, and the cerebrospinal fluid of those who are infected.HIV is most often transmitted through sexual intercourse or the transfer of contaminated bloodfrom one person to another.Health providers should be aware of the guidelines for safe sexual practices and should advisetheir patients to practice safe sex
 
HIV (-) TEST
Either not been exposed by HIV and are not infected or were exposed to HIVtapi belum terbentuk antibody.
Seroconversion (apaan tuh??? Seroconversion
change dari HIV (-) antibody test jadi HIV (+)antibody test) most commonly occurs 6 to 12 weeks after infection, although in rare casesseroconversion can take 6 to 12 months.2.Counseling
Apa aja indikasi untuk HIV testing?
look table !!
 Tapi, person who wants to be tested should probably be tested. The reasons for requesting atest should be ascertained to detect unspoken concerns and motivations that may meritpsychotherapeutic intervention.
Apa aja yang dilakukan saat pretest dan posttest?
look table !!!3.Confidentiality
 The results of an HIV test can be shared with other members of a medical team, although theinformation should be provided to no one else except in the special circumstances.
 The patient should be advised against disclosing the results of HIV testing too readily toemployers, friends, and family members; the information could result in discrimination inemployment, housing, and insurance.
If, however, a treating physician knows that a patient who is HIV infected is putting anotherperson at risk of becoming infected, the physician may try either to hospitalize the infectedperson involuntarily (to prevent danger to others) or to notify the potential victim.
CLINICAL FEATURE
1.Non neurological Factor
About 30 percent of persons infected with HIV experience a flulike syndrome 3 to 6 weeksafter becoming infected; most never notice any symptoms immediately or shortly after theirinfection.
Flu-like syndrome kayak gimana? fever, myalgia, headaches, fatigue, gastrointestinalsymptoms, and sometimes a rash. The syndrome may be accompanied by splenomegaly andlymphadenopathy.
Apa aja penyakit yang bisa disebabkan oleh AIDS?
look table!!!2.Neurological Factor
Symptoms such as photophobia, headache, stiff neck, motor weakness, sensory loss, andchanges in level of consciousness should alert a mental health worker that the patient shouldbe examined for possible development of a CNS opportunistic infection or a CNS neoplasm.
HIV infection can also result in a variety of peripheral neuropathies that should prompt mentalhealth clinicians to reconsider the extent of CNS involvement.3.Psychiatric Syndromea.HIV-associated dementiab.Deliriumc.Anxiety disorderd.Depressive disorder
A range of 4 to 40 percent of those infected with HIV have been reported to meet thediagnostic criteria for depressive disorders.
Depression is higher in women than in men.e.Adjustment disorderf.Mania
Mood disorder with manic features, with or without hallucinations, delusions, or a disorderof thought process, can complicate any stage of HIV infection, but most commonly occursin late-stage disease complicated by neurocognitive impairment.g.Substance abuse
Patient tempted to use substance regularly to deal with depression or anxiety.h.Suicide
 The risk factors for suicide among persons infected with HIV are having friends who diedfrom AIDS, recent notification of HIV seropositivity, relapses, difficult social issues relatingto homosexuality, inadequate social and financial support, and the presence of dementiaor delirium.i.Psychotic disorder
Psychotic symptoms are usually later stage complications of HIV infection
needantipsychotic. j.Worried well
Patient are seronegative and disease free TAPI anxious about contracting the virus.
Some are reassured by repeated negative serum test results.
 Their worried well status can progress quickly to generalized anxiety disorder, panicattacks, obsessive- compulsive disorder, and hypochondriasis.
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