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n CME : Your SA Journal of CPD - Psychiatric aspects of HIV / AIDS in adolescents : main article
Psychiatric disorders are common in adolescents. HIV infection and its psychiatric consequences are also common in adolescents. It is important to identify psychiatric disorders both in terms of HIV prevention and treatment.
The primary developmental task of adolescence is to establish one's identity. This results in an increasing need for independence and may result in denial of serious illness, rebellion against authority figures and questioning of facts about HIV infection and treatment.
Psychiatric disorders associated with HIV infection in adolescents include neurocognitive disorders, psychosis and depression. All these disorders may require treatment with ART as well as psychotropic medication. It is important to be aware of drug interactions and side-effects of both ART and psychotropic medications.
Common psychosocial issues in adolescents with HIV infection include adherence, disclosure, bereavement and sexuality.
Effective management of these psychosocial issues requires a collaborative approach with both the adolescent patient and his or her caregiver.
Adherence in adolescents is influenced by the extent of disclosure and acceptance of the illness, the health status of caregivers, the family environment in which the adolescent lives, and the adolescent's need for independence.
Disclosure is a process in adolescents that is dependent on the individual's developmental phase as well as family and caregiver concerns and needs in this regard.
HIV-positive adolescents may experience multiple bereavements, and these bereavements may result in significant disruption and other losses at the same time (such as loss of home, financial security and schooling).
Sexuality develops during childhood and adolescence. Caregivers are the most appropriate people to discuss sexuality with their children and adolescents but seldom feel comfortable doing so. Health care workers need to assist them in undertaking this task.
Sex education and discussions around sexuality should occur over time in the context of a trusted relationship and in the context of other developmental issues.
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