HIV affects the immune system, particularly the lymphocytes and monocytes that protect the body. Through a complicated process, the virus enters the body and reverses to DNA occurs transcription of the RNA. The viral DNAs then join the host DNA, making many viral RNAs, and produce viral proteins. Bottom line is that the virus attaches to a good cell and then mutates and multiplies .
HIV first attacks the lymph nodes via dendritic cells, macrophages, and then infects the helper T cells. After the viral parts are assembled, they attach to the cell membranes, causing a cascade of events, leading to the breaking apart of the host membrane and the destruction of helper R cells.The attack on the immune system causes impairment and dysregulation of the immune system ;thus, weakening to foreign bacteria and viruses. Opportunistic infections are common and death is the result of these opportunistic infections and not the HIV.
HIV patients are living longer than ever, and the disease is being treated as any other chronic process, with appropriate interventions and treatments. One of the many co factors in dealing with the virus is depression. The individuals are faced with many life challenges such as social stigmatization, economic issues, isolation and a lack of peer support. Cognitive behavioral interventions have been long utilized for HIV patients; however, the cost of such programs can be extensive.
Cognitive–behavioral self-help programs (CBS) have the potential to be cost effective and employ positive results in reducing depressed mood. The self-help program is based on cognitive behavioral therapy. The content of the program is developed after the completion of a study on predictors of psychological well-being among people living with HIV. Intervention programs for people with HIV should focus on the content of thoughts and bringing about effective cognitive change, combined with working on goal adjustment. Respondents reported a high need for relaxation and finding new goals in life .In addition, 50% reported a need for learning coping skills for living with HIV .The self help program consists of a CD, a workbook, and a program. Participants practice mindfulness relaxation techniques along with 30 minute writing sessions, disclosing their emotional and mental states. A small study revealed an improvement of depressive states .
Recent literature has shown cognitive behavioral therapy effective for improving common mental illness associated with physical disease. Many patients see their primary healthcare provider for the disease process itself; however, the goal is to improve contact time with providers for extenuating factors such as depression and anxiety associated with the illness. Because traditional CBT have substantial cost factors, many self-help CBT programs are being implemented. Self-help is described as the use of written or computerized documents along with audio or video instructions. Twenty-nine studies and 4739 patients were compared utilizing self-help CBT. The results were promising in that a significant number of patients had reduced depressive symptoms, a lower anxiety level and improved quality of life .
Depression can have a debilitating effect on HIV patients, and perhaps accelerate the disease process. Accessibility to CBT programs can be an issue; thus, self-help CBT is a potential answer for many HIV patients. One study utilized 67 randomly assigned patients with HIV to participate in a web based CBT program and a non-web based program. Those participants that stayed with the web based program failed to demonstrate the differences between groups at study-end. However, analyses of moderators indicated that patients who improved on well-being had been diagnosed with HIV longer, when compared to non-responders. Patients who improved on life satisfaction had also been participating in web-based therapy longer; supporting the finding, which coping with HIV is dependent on time since diagnosis and the advent of CBT. Those with indications of mild depressive symptomatology may also benefit from web based CBT .