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.