With the number of people being infected with the HIV virus rising daily, many wonder why people continue to engage in risk behaviour. Studies conducted recently by the Botswana Ministry of Health shed some light on this question. The following reasons were discovered:
· Lack of knowledge
Many people still do not know how HIV is transmitted and lack education about safer sexual acts. Many are unaware that they may be at risk of HIV infection, while others do not know how or where to get a condom.
· Attitudes and beliefs
Many people continue to deny that they are at risk of HIV infection. Others feel that they are not capable of changing their risk behaviour, enjoy their current behaviour, or think that their current behaviour is what is expected. Many do not think that condoms are acceptable, that they reduce sexual pleasure, or that if they use a condom it is a sign that they have HIV infection.
· Lack of skills
Many have no idea how to use a condom properly and do not have the skills to practice safer sexual acts, while others do not know how to negotiate safer sexual acts.
The status of women gives them little chance to negotiate safer sexual practices and many people have limited access to condoms, health care services, counseling and testing. Local policies such as migrant labour separates families and often religious, moral or social constraints make it difficult for people to talk about condoms.
Recently the counsellors at the Depression and Anxiety Support Group attended a training course on HIV/Aids training. You can contact the group, Mondays to Fridays, between 8am and 7pm, and on Saturdays, between 8am and 5pm, on (011)783-1474/6. Although the Group’s focus is on depression and the anxiety disorders, with the HIV statistics soaring, the more people trained to help people cope with learning that they are HIV positive, the better. Also it is important to train as many people as possible so that they can educate others and help them to change their behaviour. According to the Botswana Ministry of Health, the four key aspects to behaviour change include:
Accurate information remains the starting point for promoting behaviour change. This includes:
- information about HIV/AIDS and other STDs
- routes of transmission
- means of prevention
- living with and care of people with HIV and AIDS
· Motivation to Act
As well as the facts, people need to know that these facts affect them - that they are personally at risk. Role models are always a good idea. It gives people someone to follow when they decide to change their sexual behaviour to protect themselves from HIV/AIDS and other STDs.
· Power/ability to act
People need to be taught new skills to put this knowledge into practice. Many also need to be empowered to use these skills, through the teaching of negotiation skills. This is especially important for women.
· Changing environment
An individual’s sexual behaviour is influenced by the society and culture in which he or she lives, and the services which are available. In many cultures the challenge is to change some very fundamental beliefs about sexual practice.
Montele Molefe, the training counsellor stated that: “The statistics are really quite shocking. For every ten people that learn that they are HIV positive, three to four of them become suicidal or experience suicidal thoughts.” Although it is advisable for people to be counselled by trained counsellors who are also HIV positive, as they are more able to convey genuine empathy and understanding, where the Group comes in is that here the counsellors are more qualified to be able to deal with the depression, anxiety and suicide that often accompanies HIV/AIDS. Working together seems to be the best solution.
For many people who are not HIV positive, it is hard to imagine what it would be like, and many people actually think that depression and anxiety are a ‘normal reaction’ which is to be expected. This in fact is not the case.
Obviously a certain amount of anxiety is normal, but for a person to develop a full-blown anxiety disorder or depression is not. It is highly detrimental for a person with HIV/AIDS to be suffering from a simultaneous mood or anxiety disorder. Studies have shown that when you are stressed, depressed or anxious, the levels of certain hormones in your body are higher. One of these is cortisol, which inhibits the functioning of your immune system. With the HIV virus already attacking your immune system, it is crucial to keep stress levels down as much as possible.
Therefore it is essential for the co-occurring depression or anxiety to be treated. There are a variety of treatment options available from psychotherapy to medication. According to Professor Michael Gitlin
Stats about comorbidity etc - while better for people to be counselled by HIV positive people who can empathise and give advise etc, counsellors here trained to deal with the depression and anxiety side of the disorder. For more info contact DASG
Comorbidity discuss and nbness of family caregivers etc. nbness of treating both and therapy for caregivers