EDUCATIONAL SESSION 1: HIV, the Viral Life Cycle & Understanding HAART and Adherence

CASE STUDY

EDUCATIONAL SESSION 1: HIV, the Viral Life Cycle & Understanding HAART and Adherence

Debra is a 40-year-old woman who was diagnosed with HIV four-years ago. She decides, after her first visit that she is not ready to deal with this situation. After hearing from you she comes in to learn about the intervention. She is now considering startingHIV care and treatmentbut only if she can get over her fears about HIV and concerns about people finding out she is HIV-positive.

This change of heart comes about because she has been experiencing difficulty in breathing and night sweats. She developed a persistently high fever and now is extremely dehydrated. This health scare eventually led her adult daughter to take her to the emergency room (ER). She tearfully decides to disclose her HIV status to the emergency room staff but not her daughter. She also discloses that she is diabetic and that she does not take her diabetic medication on a regular basis.

The ER doctor decides to run a battery of tests, including an HIV test to confirm her HIV-positive status. After receiving the laboratory results, the ER doctor informs her,in addition to confirming her HIV-positive status, that she has a severe sinus infection. In addition, she is informed that her CD4 Count (or T-Cells) has dropped from 350 T-Cells to 150 T-Cells and her viral load is now in the millions of copies.

Debra goes into an emotional tailspin because she now knows her health condition is critical. The ER doctor assures her that she is not dying but needs to make a decision about starting HIV treatment. This is not an easy decision for her because she has not disclosed her HIV status to anyone else. You see Debra’s family is well know in the community and she feels that disclosing her HIV status will not only shame her but will also bring shame to her partner, family, and her friends.

Additionally, she is afraid that her mother will revert to treating her badly like she did when she found out that Debra was using drugs, which caused her to lose her job and children.