WOMEN EMOTIONAL HEALTH
It
is a normal reaction to feel down, or even devastated, after being
diagnosed with HIV or during the course of the disease. A support
network can help you cope with tough times. But when feelings become
severe and limit the energy you need to stay focused on being healthy,
you should talk with your doctor. People living with HIV are more likely
to have depression, as well as other mental illnesses. HIV and its
treatment also can affect brain function, including thinking, mood, and
behavior. Many of these problems can be helped with treatment.
Depression
HIV
does not directly cause depression. But depression is twice as common
in people with HIV as in the general public. Depression is a separate
medical condition that needs to be treated. Research shows that
depression can speed up HIV's progression to AIDS.
Symptoms of depression include:
- Sadness, anxiety, and irritability
- Loss of interest in normally pleasurable activities
- Feelings of guilt, worthlessness, or hopelessness
- Weight loss
- Loss of appetite
- Sleep problems
- Fatigue
- Loss of concentration
- Low sex drive
- Thoughts of suicide
Diagnosing
depression can be hard in someone with HIV. Some HIV symptoms and side
effects of HIV drugs are the same as those of depression. These include
fatigue, low sex drive, little appetite, confusion, nightmares,
nervousness, and weight loss. But a true loss of interest in activities
that someone used to enjoy is a sign that a person is depressed.
Treatment,
such as talk therapy and antidepressants, usually can help people with
depression. Antidepressants are usually safe for people with HIV. But
there may be interactions with other drugs, so it's important that you
and your doctor watch for side effects. Do not use St. John's wort, a
drug that some people use to treat mild symptoms of depression. It has
harmful interactions with HIV medicines.
Problems in Brain Function
HIV,
as well as some of the medicines used to treat HIV, can affect brain
function. Memory problems, confusion, slowed thinking, problems talking,
changes in mood and behavior and other problems can greatly affect
quality of life, and complicate HIV treatment. Some of these problems
can be improved or reversed with treatment. Counseling can also help
people learn to cope with changes in brain function. Talk to your doctor
if you or someone you care for begins to show signs of decreased mental
function.
HIV and your Cervix
Cervical
dysplasia and cancer are associated with human papillomavirus (HPV), a
sexually transmitted virus. Carcinogenic strains of HPV may, in
conjunction with other factors, cause dysplasia and cancer not only of
the cervix, but also of the vulva, vagina, and anus.
HIV-infected
women have a higher prevalence of HPV infection than HIV-uninfected
women, and are 5 times more likely to develop cervical dysplasia, or
squamous intraepithelial lesion (SIL), precursors to cervical cancer.
They may also have a higher risk of invasive cervical cancer and tend to
have more aggressive forms of cervical cancer. Invasive cervical cancer
is an AIDS-defining illness.
The
risk of high-grade cervical lesions appears to be higher in women with
advanced immunodeficiency than in women with preserved CD4 cell counts.
Other
risk factors for dysplasia and cervical cancer include African American
ethnicity, a history of smoking, younger age at onset of sexual
intercourse, and multiple sexual partners.
Effective antiretroviral therapy (ART) with immune reconstitution has not been shown to prevent the progression of dysplasia.
Screening
for cervical dysplasia and appropriate intervention in women with
high-grade dysplasia are effective in preventing cervical cancer.
Frequent
monitoring and careful follow-up in women with low-grade lesions are
essential for preventing progression to invasive disease. Papanicolaou
testing should be performed routinely on all HIV-infected women, with
testing initiated at diagnosis, repeated 6 months after the first test,
then performed annually thereafter if the results are normal.
Contact:
The Jamaica Cancer Society
16 Lady Musgrave Road
Kingston 5
Jamaica, W. I.
Telephone:
1 (876) - 927 - 4265
Fax:
1 (876) - 978 - 1918
Email:
Telling Your Kids
A
major concern for mothers with HIV is whether to tell their kids about
their HIV and when and how they will do it. Opinions on how mothers
should handle this hard decision are mixed. Some studies show that open
communication about the illness to their kids is better than not telling
them. Children may already know something is wrong; keeping the illness
a secret can confuse children and make them feel anxious. Other studies
have found that children have negative reactions to being told, like
behavior problems, sexual risk-taking behavior, and lower school
performance. Several studies have shown that if a HIV-positive mother
reveals her status, telling a child to keep her health condition a
secret is stressful for that child and as a result, that child may have
behavior problems.
In one study, women with HIV who told their children about their illness were interviewed.
The women recommend these tips for talking to your kids about your HIV status.
- Think about why you want to tell your children about your HIV status. Make sure you're ready and they're ready to listen.
- Educate yourself about HIV so you can talk to your children about the illness.
- Plan for what you're going to say to your children.
- Consider
how healthy you are right now and how healthy you will be later. It
might be better to talk to your child when you're feeling healthy and
can show your child a healthy, positive attitude.
- Think
about other things going on in the family. It may not be the best time
to tell your child when there are other stresses in the family.
- After
you tell your children, get them additional support. They could talk to
a health professional who can talk more with your children about HIV.
