Two weeks back, we were
talking about the challenges of referring patients with mental health issues to
psychiatry service. During the
discussion, we mentioned how stigma and discrimination can lead to depression
and suicidal ideations, especially among newly diagnosed people living with HIV (PLHIV).
The process of testing
itself is imbedded in a private and confidential setting, with counselling to
provide psychological support when one finds out about the diagnosis. Disclosure to family and loved ones of one’s
status becomes difficult, considering that one needs to open oneself up to the
risk of rejection and isolation. It is
painful to realize that you may not be accepted, and that you may be shunned
from polite society.
I know of a prominent
Filipino doctor who died of suffocation, refusing intubation. He had an opportunistic fungal pneumonia, and
he wanted to die because he could not accept that he had HIV/AIDS. So he refused all interventions, and signed
an advance directive to allow him to die.
Had he received psychiatric help for the depressive feelings he must
have had, who knows? He might have been helping the Filipino poor today,
providing health service delivery.
Last week, we had a
technical meeting with the Department of Health, WHO and UNICEF on the
implementation of the prevention of mother to child transmission of HIV in the
Central Visayas. During this meeting, we
discussed the challenges of treating, caring and supporting pregnant women
living with HIV and their families.
There is a new administrative order being drafted which integrates
prevention of mother to child transmission of HIV in all levels of healthcare. In an instant, I could imagine all the
challenges we would have, so we requested that this new order be implemented
with strong programs on stigma reduction and HIV awareness programs especially
for healthcare providers.
During a regional forum
with the Health Policy Development Program discussing the challenge of reaching
the poor through a continuum of care, it was mentioned that almost 50% of
people who inject drugs were HIV-positive.
These people also deal with mental health issues which drove them to use
drugs in the first place. How do we
integrate HIV in all levels of healthcare without addressing first the basic
mental health issues of key affected population – male who have sex with males,
IV drug users, female sex workers?
Have you had an HIV
test? Until the HIV test becomes as
routine as a complete blood count, it may be difficult to encourage HIV testing
at the community level, and in all levels of healthcare. We’ve got a lot of things to talk about HIV
yet.
The Duke and Duchess of
Cambridge and Prince Harry had a conversation about putting their HeadsTogether for mental health. They realized that all their
personal advocacies had the central point of mental health – that simply
talking about things can already be therapeutic, like medicine.
What are examples of mental health issues faced by PLHIV?
How can mental health issues affect the programmatic approach to prevent HIV/AIDS?
What strategies may help reduce stigma and discrimination among PLHIV.
How do we move forward?
We had a #HealthXPH tweetchat on this topic last Saturday. Here are some of the inputs from those who participated:
Yenyen Delgado shares an infographic for healthcare workers.
We had a #HealthXPH tweetchat on this topic last Saturday. Here are some of the inputs from those who participated:
Yenyen Delgado shares an infographic for healthcare workers.
Roland talks about testing.T3 This is a great infographic for healthcare workers. #HealthXPH pic.twitter.com/lRM6C2rvwR— Yenyen Delgado (@yenerts) July 15, 2017
Cocoy mentions reaction to diagnosis.Filipino teens generally think that getting tested is a message itself that you could have HIV, or a sexually active person, etc #HealthXPh https://t.co/Ght7Y5ZS3W— Roland Vergel Acasio (@Sir_Lando) July 15, 2017
Shereese talks about careers of PLHIV.The reaction to diagnosis is highly influenced by culture, level of understanding, and upbringing. #HealthXPh— Cocoy Calderon, M.D. (@cocoycalderonmd) July 15, 2017
Renier talks about access to services.Careers don't need to be destroyed due to contracting a disease. We now know, w/ tx & precautions, ppl can lead normal lives #healthxph— ShereeseM, MS/MBA (@ShereesePubHlth) July 15, 2017
Stephanie suggests screening for anxiety and depression among PLHIV.To address PLHIV mental health, stakeholders should make sure HIV services, whether health-related or otherwise, are accessible. #healthxph— Renier Louie B. Bona (@renierbona) July 15, 2017
Chin-chin talks about HIV awareness to reduce stigma.T3 Anxiety and depression screening for those with the PLHIV status, asking the right questions yields helpful answers. #healthxph— Stephanie Miaco, MD (@thestreetgazer) July 15, 2017
Miko sends a positive outlook for the Philippine HIV epidemic.T3. Awareness about HIV is important to reduce stigma. Knowledge leads to understanding and with understanding comes Compassion. #HealthXPh— Chin-Chin (@chinchinmd) July 15, 2017
...and with that, we remove the elephant in the house and continue to talk about HIV to improve awareness and attitudes towards PLHIV.Let's all work together in a HIV-Free Philippines. We have so much experts that can work on this. #HealthXPh https://t.co/8tnRjXUjAg— Miko (@ohitsmiko) July 15, 2017
