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HIV and AIDS
Cumulative Totals Through 2003 in the USA
 Number
of Patients Diagnosed: 929,985
 Number
of Deaths: 524,060
 Greatest
 Second
% of Cases: Between Ages 35 - 44
Greatest %: Between Ages 25 - 34
During 2003 of the People Diagnosed in USA:
Caucasians: 12,222
African Americans: 21,304
Hispanics: 8,757
Asian / Pacific Islanders: 497
American Indian / Alaska Natives: 196
 #1:
Male to Male Sexual Contact
 #2:
Heterosexual Contact
 #3:
Injection Drug Use
A
disease that develops when the HIV virus
invades the body and disrupts the immune
system so that it cannot ward off deadly
infections.
 Life
threatening disease that sooner or later
kills almost everyone who has it.
 1977
– 1978: First cases of AIDS probably
occur in the US, Haiti and Africa.
 1981: Link with sexual transmission
suspected.
 1982: First educational efforts started in US.
AIDS also linked to blood transfusions and IV
drug use.
 1985: Blood test developed to detect HIV
antibodies. The US begins screening donated
blood.
First controlled clinical trials of anti-HIV
drugs.
 1988:
The Names Project creates the AIDS
Quilt to help publicize the epidemic.
 1989:
 1996:
Over 100,000 AIDS cases in US
Discovery of “Triple Whammy” doses
to increase life expectancy.
In the past, life expectancy was 6 months – 2
years. Now with the advancement of
medicine, HIV patients are living 10 – 20
years without developing AIDS.
Ruth Living With AIDS
Patients with AIDS have different signs &
symptoms as the infection progresses.
 Some Symptoms Include:
 Fever
 Fatigue
 Diarrhea
 Skin Rashes
 Night Sweats
 Loss of Appetite
 Swollen Lymph Glands
 Significant Weight Loss
 Memory or Movement Problems
 Misconception
#1:
AIDS can be spread by kissing.
New research suggests that saliva from a
healthy person actually inactivates the AIDS
virus.
 Misconception
#2:
AIDS can be spread by touching.
HIV is present in sweat and tears; however, its
concentration in these fluids is extremely
low. For persons coming into contact with a
person infected the risk of transmission is
nonexistent.
 Misconception
#3:
AIDS can be spread by sharing eating utensils.
The HIV concentration in saliva is too low to
cause infection and saliva inactivates the
virus.
 Misconception
#4:
A person can contract AIDS by being near a
someone with it.
It is important to remember that HIV is not
transmitted through the air, as influenza or
cold viruses are. HIV is spread solely through
the exchange of bodily fluids, primarily
semen and blood.

The Five Common Modes of Transmission:
Person to Person transmission through sexual
behavior.
 Use of HIV contaminated injection equipment by
more that one person involving the exchange of
blood. Examples: Needles for injecting drugs
and tattoo needles
 Mother to Infant transmission during pregnancy,
labor and delivery or breast feeding.
 Transfusion of infected blood or blood products.
 Contact with infected feces that enter the
bloodstream.

 The
development of AIDS can be though of as
a five-stage process.
 First Stage: Acute Infection: The virus
enters the body and replicates itself.
 Second Stage: may take one of two forms


Acute Symptomatic Illness (primary HIV
infection): Within the first 2-4 weeks, some
people experience fever, weakness, sore throat,
skin rashes and lethargy. This stage can last 1-2
weeks.
Immune Reaction Against HIV: The body begins
to produce antibodies to fight infection. Within 2
months after infection, typical HIV testing
procedures can detect the virus.

Third Stage: Asymptomatic HIV Infection: The
HIV-infected person shows no symptoms for 6
months to 15 years or longer, depending on
medical treatment.

Fourth Stage: Chronic or Symptomatic Infection:
This stage was previously called AIDS-related
complex (ARC) because it was believed that full
blown AIDS would be seen after these symptoms
occurred. Medical interventions have delayed
the onset of AIDS in the last 10 years. Symptoms
include fever, fatigue, diarrhea, skin conditions,
thrush, and bacterial, fungal, and parasitic
infections.
 Final
Stage: AIDS: The person develops one
or more of the 26 AIDS-defining opportunistic
infections or has a T-helper cell count below
200 cells in conjunction with the HIV
infection.
 An
AIDS antibody test is available. A positive
test result does indicate that the person has
been infected by HIV and can transmit to
others. It does not tell if the individual will
eventually develop signs of illness related to
the viral infection or, if the person does, how
serious the illness will be.
 To
date, there is no cure or vaccine for HIV
or AIDS.
 The most popular medication AIDS and HIV
patients take is AZT, the original medication
for AIDS patients.
 The Triple Whammy regimen can affect the
virus so significantly that it does not show up
on a blood test in some people.
 The purpose of these medications is to block
the deterioration of the immune system.
 Despite
increased knowledge and education
about AIDS virus, a stigma continues to be
attached to people with AIDS.
 The stigma comes not only from the public,
but also professional health care workers.
 The general population often discriminates
against homosexual men with the disease and
see the disease as a punishment from God for
the way they live.
 Being a social outcast only worsens the
trauma of AIDS.
 Crisis
Workers providing counseling for those
suffering from AIDS should keep in mind
various issues the individual faces.
 Identification
of these issues furthers the
worker’s understanding of the subjective
distress and helps the worker to choose
coping alternatives.
 #1:
Diagnosis: Whether the client has tested
positive for HIV or has full blown AIDS?
 #2:
Inception: How the person became
infected: by at-risk sexual contact; sharing of
needles; or blood transfusions?
 #3:
Lifestyle: Do the person’s significant
others know about his or her sexual
behaviors, drug use, or other risky behaviors?
 #4:
Marital Status: Involvement of
significant others?
 #5:
Developmental Stage
 #6:
Personality Style: Dependency issues,
losses, narcissism?
 #7:
Cultural Background
 #8:
Social Support Network
 Individuals
diagnosed with AIDS often suffer
as much psychologically from the diagnosis as
they do physically.
 With
proper counseling, patients may be able
to reduce their feelings of stress and
depression, enabling them to enjoy a better
quality of life.
 Counseling
can also help clients address
issues of death and dying and the denial,
anger, and frustration.
 Isolation
is often found in patients and often
compounded when the family and friends of
the patient withdrawal once the AIDS
diagnosis becomes known.
 Counseling
must also focus on the
psychological issues brought on by the stigma
associated with the disease, homophobia,
and loss of friends, work, housing, insurance,
and other essentials of life.
 In
1991, the Ackerman Institute AIDS Project
developed a training video dealing with crisis
intervention for HIV / AIDS patients and their
families.
 It
describes the types of psychological and
interpersonal issues involved in the various
stages of distress in which clients are first
seen by the crisis worker.
 Group

#1: The Worried Well
Many of these individuals experience sexual guilt
caused by the fear of AIDS.

Example: If a gay man has been living as a
heterosexual, issues of disclosure about his
homosexuality often need to be disclosed.
 Issues of suicide must be taken seriously!! A
bisexual man may believe suicide would be
preferable to telling his wife and children that he
has engaged in risky behaviors such as oral or anal
sex with a gay man.
 Group

#2: Clients in Denial
A sense that, “It could never happen to me”.
Some people may suspect that they have been
infected but may have irrational thoughts such
as, “If I find out, I may really die”.

Example: A person believes they are infected, but are
in denial, and do not restrict their sexual behavior
therefore put others at risk.
 The crisis worker can explain how finding out their
status can help them prolong life through
medication, nutrition and physical wellness.
 Group
#3: Clients Dealing with HIV-Positive
Test Result

Many issues must be explored during the time
following the news of the result. The client’s
energy will be best spent in attending optimistic
support groups, complying with medications, and
learning to engage in healthy behaviors that lead
to good health and low risk for infecting others.

Some clients may fear losing their partners when they
disclose a positive result.
 Group
#4: Those Who Start to Develop
Symptoms

These clients often feel dirty and contaminated.
Fears of physical deterioration often lead to
thoughts such as, “I just want to die because I
know sooner of later it will turn into AIDS”.

The counselor can discourage the client from creating
distance form others, but instead providing disclosure
may rekindle relationships and create closeness.
 It
is very important for a client who has been
given a positive test result to follow
guidelines to help protect their health as
well as the health of those around them.
 Reduce
the number of sexual partners,
preferably to one.
 Practice safe sex, and have all sexual
partners tested.
 Use condoms.
 Clean up accidental spillage of body fluids,
especially blood and semen but also feces
and vomit. Fortunately, the AIDS virus is
destroyed easily by alcohol, hydrogen
peroxide, and bleach.
 Do not pass or receive body fluids, especially
blood and semen.
 Do
not engage in any form of sex that can
cause injury to body tissues.
 Avoid poppers and other drugs that can cloud
thinking and reduce self-control.
 Avoid intravenous drugs or other injectable
drugs.
 Follow the rules of ordinary good personal
hygiene. Give special attention to bathing
before and after sex and keeping the mouth,
teeth and tongue clean.
 Avoid sharing personal items, especially
those that may be contaminated by a small
amount of blood, such as razors and
toothbrushes.
 Case

#1:
A 32 year old male come to you just after he has
received the results of his HIV positive. He has
been living a closet gay life; his family and
employer do not know he is gay. He does not
have a current partner but has several buddies
with whom he parties. He’s depressed but feels
good physically, so he’s not very worried.
 Case

#2:
A 50 year old man comes to you on referral of
the medical social worker at the hospital. His
longtime companion of 20 years has contracted
AIDS and is currently suffering from the
opportunistic infection pneumonia. He is drained
and misses his friend’s youthfulness and lively
character.
 Case

#3:
A 30 year old man comes to you after finding out
that he is infected with the HIV virus. He found
out at the public health department. He is
married but does not have children yet. He
thinks he contracted the disease from a
prostitute. His wife does not know yet.
 Case

#4:
A female heroin addict comes to you worried that
she will get AIDS. She shares needles on a regular
basis but feels uncomfortable asking whether the
other users have been tested for HIV.
Kanal, Kristi. (2007). A Guide To Crisis
Intervention. Belmont, CA: Brooks/Cole.