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Hepatitis and Blood Borne Pathogens
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TIP 37: Substance Abuse Treatment for Persons with HIV/AIDS
Dr. Dawn-Elise Snipes, PhD, LMHC
Objectives
• Review current information about the prevention, transmission and treatment of HIV, Hepatitis and Blood Borne Pathogens
• Review current information about hepatitis transmission, symptoms and treatment.
Overview
650,000 to 900,000 in the U.S. with HIV
Approximately 3.2 million people in the US are living with Hepatitis B or C
Hepatitis A is spread by close personal contact with people or things contaminated with feces
HIV & Hepatitis B & C are most easily transmitted by contaminated blood and body fluids
The incidence of hepatitis C among people who are heavy consumers of alcohol (e.g. men that consume 4-5 alcoholic drinks a day) is 7x higher than in the general population.
Vaccines exist for Hepatitis A & B
Overview
Alcoholic hepatitis is caused by drinking too much alcohol and occurs in 20% of alcoholics or approximately 3 million people
Severe alcoholic hepatitis can develop suddenly and quickly lead to liver failure and death.
Viral Hepatitis Symptoms
Viral hepatitis symptoms are similar no matter which type of hepatitis you have. Symptoms include:
◦ Jaundice
◦ Fever
◦ Loss of appetite
◦ Fatigue
◦ Dark urine
◦ Joint and abdominal pain
◦ Diarrhea, nausea, and vomiting.
Incubation period 15-180 days
Risk-Reduction Counseling
Clinician’s goals
◦ Help and support understanding need for behavior change
◦ Assist addressing cultural practices, beliefs contributing to resisting change
◦ Assist skills development to sustain behavior change
Counseling and Testing
Pre- and posttest counseling by a trained HIV and Blood borne pathogens clinician
Counseling should:
◦ Explain limitations of tests (i.e. incubation period and false +/-)
◦ Help clients assess risks
◦ Encourage, reinforce behavior change
◦ Refer infected clients for medical care
Factors for Noncompliance
Addiction or mental health relapse
Living in an institution
Side effects
Affordability
Increasing Compliance
Write instructions
Use timer, ensuring proper dosing
Use check-sheet, notating dosage
Provide positive feedback
Empathize / Advocate regarding medication side effects
Visual cues for persons with impaired language/cognitive abilities
Avoiding Drug Resistance
Take all medications as prescribed
Drug Interactions
◦ General drug interaction checker
LEARN Sensitivity
Listen with empathy and understanding
Elicit cultural information
Acknowledge and discuss cultural differences and similarities
Recommend action, treatment, intervention incorporating cultural knowledge
Negotiate agreements and differences with client
Relapse Prevention
Events which may initiate client relapse:
◦ Taking an HIV/Hepatitis test
◦ Receiving test results
◦ Experiencing first symptoms of the disease
◦ Experiencing first disease-related hospitalization
◦ Being diagnosed with AIDS or liver cancer / liver failure
◦ Friend or significant other dying from AIDS or hepatitis
◦ Beginning medication regimen for the disease
◦ Experiencing little or no response to various medications
◦ Decreasing CD4+ T cell count or increasing viral load
Relapse Prevention Interventions
Nutrition (H)
Relaxation and stress management (A)
Grief management (A)
Recreation (A/L)
Peer support (L)
Family Counseling (L)
Sleep (T)
Medical intervention for pain
Group Therapy
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