-HIV is the virus that causes HIV infection.
AIDS is the most advanced stage of HIV infection.
-HIV is spread through contact with the blood,
semen, pre-seminal fluid, rectal fluids, vaginal fluids, or
breast milk of a person infected with HIV. In the United States, HIV is spread
mainly by having anal or vaginal sex or sharing drug injection equipment with a
person infected with HIV.
-The use of HIV medicines to treat HIV
infection is called antiretroviral therapy (ART). ART involves taking a
combination of HIV medicines (called an HIV regimen) every day.
-ART can’t cure HIV infection, but it can help
people infected with HIV live longer, healthier lives. HIV medicines can also
reduce the risk of transmission of HIV.
HIV stands for human
immunodeficiency virus, which is the virus that causes HIV infection. The
abbreviation “HIV” can refer to the virus and or to HIV infection.
AIDS stands for acquired immunodeficiency syndrome. AIDS is the most advanced
stage of HIV infection.
HIV attacks and destroys the infection-fighting CD4 cells of
the immune system.
Loss of CD4 cells makes it difficult for the body to fight infections and
certain cancers. Without treatment, HIV gradually destroys the immune system
and advances to AIDS.
How is HIV spread?
HIV is spread through
contact with certain body fluids from a person infected with HIV. These body
fluids include:
The spread of HIV from
person to person is called HIV transmission. The spread of HIV from an
HIV-infected woman to her child during pregnancy, childbirth, or breastfeeding
is called mother-to-child transmission of HIV.
In the United States, HIV is spread mainly by having sex with or sharing drug
injection equipment with someone who is infected with HIV. To reduce your risk
of HIV infection, use condoms correctly and consistently during sex, limit your
number of sexual partners, and never share drug injection equipment.
Mother-to-child transmission is the most common way that children become
infected with HIV. HIV medicines, given to HIV-infected women during
pregnancy and childbirth and to their babies after birth, reduce the risk of
mother-to-child transmission of HIV.
You can’t get HIV by shaking hands or hugging a person infected with HIV. And
you can’t get HIV from contact with objects such as dishes, toilet seats, or
doorknobs used by a person with HIV.
What is the treatment for HIV?
The use of HIV
medicines to treat HIV infection is called antiretroviral therapy (ART). ART
involves taking a combination of HIV medicines (called an HIV regimen)
every day. (HIV medicines are often called antiretrovirals or ARVs.)
ART prevents HIV from multiplying and reduces the level of HIV in the body.
Having less HIV in the body protects the immune system and prevents HIV
infection from advancing to AIDS.
ART can’t cure HIV, but it can help people infected with HIV live longer,
healthier lives. ART also reduces the risk of HIV transmission.
What are the symptoms of HIV/AIDS?
Soon after infection
with HIV, many people have flu-like symptoms, such as fever, headache, or rash.
The symptoms may come and go for a month or two after infection.
After this earliest stage of HIV infection, HIV continues to multiply but at
very low levels. More severe symptoms of HIV infection, such as chronic
diarrhea, rapid weight loss, and other signs of opportunistic infections,
generally don’t appear for many years. (Opportunistic infections are infections
and infection-related cancers that occur more frequently or are more severe in
people with weakened immune systems than in people with healthy immune
systems.)
Without treatment, HIV can advance to AIDS. The time it takes for HIV to
advance to AIDS varies, but it can take 10 years or more.
HIV transmission is possible at any stage of HIV infection—even if an
HIV-infected person has no symptoms of HIV.
How is AIDS diagnosed?
The following criteria
are used to determine if a person infected with HIV has AIDS:
The person’s immune system is severely damaged
as indicated by a CD4 count of less than 200 cells/mm3. A CD4 count measures the number of CD4 cells in a sample of
blood. The CD4 count of a healthy person ranges from 500 to 1,600 cells/mm3.
AND/OR
The person has one or more opportunistic
infections.
HIV is spread through contact with the
blood, semen, pre-seminal fluid, vaginal fluids, rectal
fluids, or breast milk from a person infected with HIV.
In the United States, HIV is spread
mainly by having sex or sharing injection drug equipment, such as needles,
with someone who has HIV.
To reduce your risk of HIV infection, use
condoms correctly every time you have vaginal, oral, or anal sex. Don’t
inject drugs. If you do, use only sterile injection equipment and water
and never share your equipment with others.
Treatment with HIV medicines (called antiretroviral therapy
or ART for short) helps people with HIV live longer, healthier lives.
Although ART can reduce the risk of HIV transmission, it’s still important
to use condoms during sex.
How is HIV spread?
HIV is spread through contact with the certain
body fluids from a person infected with HIV:
Blood
Semen
Pre-seminal fluids
Rectal fluids
Vaginal fluids
The spread of HIV from person to person is
called HIV transmission.
In the United States, HIV is spread mainly by having sex or sharing injection
drug equipment, such as needles, with someone who has HIV.
HIV can also pass from an HIV-infected woman to her child during pregnancy,
childbirth (also called labor and delivery), or breastfeeding. This spread of
HIV is called mother-to-child transmission of HIV.
In the past, some people were infected with HIV after receiving a blood
transfusion or organ transplant from an HIV-infected donor. Today, this risk is
very low because the supply of donated blood and organs is carefully tested in
the United States.
You can’t get HIV by shaking hands with, hugging, or closed-mouth kissing a
person infected with HIV. And you can’t get HIV from contact with objects such
as toilet seats, doorknobs, or dishes used by a person infected with HIV.
How can I reduce my risk of getting HIV?
Anybody can get HIV, but you can take steps to
protect yourself from HIV infection.
Get tested and know your partner’s HIV
status. Talk to
your partner about HIV testing and get tested before you have sex.
Have less risky sex. Oral sex is much less risky than
anal or vaginal sex. Anal sex is the most risky type of sex for the spread
of HIV.
Limit your number of sexual partners. If you have more than one sexual
partner, get tested for HIV regularly. Get tested and treated for sexually
transmitted infections (STIs), and insist that your partners do, too.
Having an STI can increase your risk of becoming infected with HIV.
Talk to your health care provider about
pre-exposure prophylaxis (PrEP). PrEP is an HIV prevention method that involves taking
an HIV medicine every day. PrEP is intended for people who don’t have HIV
but who are at high risk of sexually transmitted HIV infection. PrEP
should always be combined with other prevention methods, including condom
use.
Don’t inject drugs. But if you do, use
only sterile drug injection equipment and water and never share your
equipment with others.
I am HIV positive but my partner is HIV negative.
How can I protect my partner from HIV?
Take HIV medicines daily. Treatment with HIV
medicines (called antiretroviral therapy or ART for short) helps people with
HIV live longer, healthier lives. ART can’t cure HIV infection but it can
reduce the amount of HIV in the body. Having less HIV in your body will reduce
your risk of passing HIV to your partner during sex. For added protection, you
can also talk to your partner about taking PrEP.
To protect your partner, use condoms correctly
every time you have sex. Even if you are taking HIV medicines, remember it’s
still important to use condoms.
If you inject drugs, don’t share your needles, syringes, or other drug
equipment with your partner.
Are HIV medicines used in other situations to
prevent HIV infection?
Yes, HIV medicines are also used for
post-exposure prophylaxis (PEP) and to prevent mother-to-child transmission of
HIV.
Post-exposure
prophylaxis (PEP)
PEP is the use of HIV medicine to reduce the
risk of HIV infection after a possible exposure to HIV. PEP may be used, for
example, after a person has sex without a condom with a person who is infected
with HIV or after a health care worker is accidentally exposed to HIV in the
workplace. To be effective, PEP must be started within 3 days after the
possible exposure to HIV.
Prevention of mother-to-child transmission of HIV
Pregnant HIV-infected women take HIV medicines
during pregnancy and childbirth to reduce the risk of passing HIV to their
babies. Their newborn babies also receive HIV medicine for 6 weeks after birth.
The HIV medicine reduces the risk of infection from HIV that may have entered a
baby’s body during childbirth. HIV-infected women living in the United States
should not breastfeed their babies. In the United States, baby formula is a
safe and healthy alternative to breast milk.
Mental Health Awareness uses a green ribbon to show cause support. It is important to receive help when needed for a mental health health problem or illness.
If unsure where to go for help, talk to someone you trust who has experience in mental health—for example, a doctor, nurse, social worker, or religious counselor. Ask their advice on where to seek treatment. If there is a university nearby, its departments of psychiatry or psychology may offer private and/or sliding-scale fee clinic treatment options. Otherwise, check the Yellow Pages under mental health, health, social services, crisis intervention services, hotlines, hospitals,or physicians for phone numbers and addresses. In times of crisis, the emergency room doctor at a hospital may be able to provide temporary help for a mental health problem, and will be able to tell you where and how to get further help.
Listed below are the types of people and places that will make a referral to, or provide, diagnostic and treatment services.
Cancer is a term used for diseases in which abnormal cells divide without control and are able to invade other tissues. Cancer cells can spread to other parts of the body through the blood and lymph systems.
Cancer is not just one disease but many diseases. There are more than 100 different types of cancer. Most cancers are named for the organ or type of cell in which they start - for example, cancer that begins in the colon is called colon cancer; cancer that begins in melanocytes of the skin is called melanoma.
Cancer types can be grouped into broader categories. The main categories of cancer include:
Sarcoma - cancer that begins in bone, cartilage, fat, muscle, blood vessels, or other connective or supportive tissue.
Leukemia - cancer that starts in blood-forming tissue such as the bone marrow and causes large numbers of abnormal blood cells to be produced and enter the blood.
Lymphoma and myeloma - cancers that begin in the cells of the immune system.
Central nervous system cancers - cancers that begin in the tissues of the brain and spinal cord.
Borderline personality disorder (BPD) is a
serious mental illness marked by unstable moods, behavior, and relationships.
In 1980, theDiagnostic and Statistical Manual for Mental Disorders, Third
Edition(DSM-III) listed BPD as a diagnosable illness for the first time.
Most psychiatrists and other mental health professionals use the DSM to
diagnose mental illnesses.
Because some people with severe BPD have brief
psychotic episodes, experts originally thought of this illness as atypical, or
borderline, versions of other mental disorders. While mental health experts now
generally agree that the name "borderline personality disorder" is
misleading, a more accurate term does not exist yet.
Most people who have BPD suffer from:
·Problems with regulating emotions and thoughts
·Impulsive and reckless behavior
·Unstable relationships with other people.
People with this disorder also have high rates
of co-occurring disorders, such as depression, anxiety disorders, substance
abuse, and eating disorders, along with self-harm, suicidal behaviors, and
completed suicides.
Research
on the possible causes and risk factors for BPD is still at a very early stage.
However, scientists generally agree that genetic and environmental factors are
likely to be involved.
Studies
on twins with BPD suggest that the illness is strongly inherited. Another study
shows that a person can inherit his or her temperament and specific personality
traits, particularly impulsiveness and aggression. Scientists are studying
genes that help regulate emotions and impulse control for possible links to the
disorder.
Social
or cultural factors may increase the risk for BPD. For example, being part of a
community or culture in which unstable family relationships are common may
increase a person's risk for the disorder. Impulsiveness, poor judgment in
lifestyle choices, and other consequences of BPD may lead individuals to risky
situations. Adults with borderline personality disorder are considerably more
likely to be the victim of violence, including rape and other crimes.
Signs & Symptoms
According to the DSM, Fourth Edition, Text
Revision (DSM-IV-TR), to be diagnosed with borderline personality disorder, a
person must show an enduring pattern of behavior that includes at least five of
the following symptoms:
·Extreme reactions—including panic, depression,
rage, or frantic actions—to abandonment, whether real or perceived
·A pattern of intense and stormy relationships
with family, friends, and loved ones, often veering from extreme closeness and
love (idealization) to extreme dislike or anger (devaluation)
·Distorted and unstable self-image or sense of
self, which can result in sudden changes in feelings, opinions, values, or
plans and goals for the future (such as school or career choices)
·Impulsive and often dangerous behaviors, such as
spending sprees, unsafe sex, substance abuse, reckless driving, and binge
eating
·Recurring suicidal behaviors or threats or
self-harming behavior, such as cutting
·Intense and highly changeable moods, with each
episode lasting from a few hours to a few days
·Chronic feelings of emptiness and/or boredom
·Inappropriate, intense anger or problems
controlling anger
·Having stress-related paranoid thoughts or
severe dissociative symptoms, such as feeling cut off from oneself, observing
oneself from outside the body, or losing touch with reality.
Seemingly mundane events may trigger symptoms.
For example, people with BPD may feel
angry and distressed over minor
separations—such as vacations, business trips, or sudden changes of plans—from
people to whom they feel close. Studies show that people with this disorder may
see anger in an emotionally neutral face and have a stronger reaction to words
with negative meanings than people who do not have the disorder.
Suicide and Self-harm
Self-injurious behavior includes suicide and
suicide attempts, as well as self-harming behaviors, described below. As many
as 80 percent of people with BPD have suicidal behaviors, and about 4 to 9 percent
commit suicide.
Suicide is one of the most tragic outcomes of
any mental illness. Some treatments can help reduce suicidal behaviors in
people with BPD. For example, one study showed that dialectical behavior
therapy (DBT) reduced suicide attempts in women by half compared with other
types of psychotherapy, or talk therapy. DBT also reduced use of emergency room
and inpatient services and retained more participants in therapy, compared to
other approaches to treatment.
Unlike suicide attempts, self-harming behaviors
do not stem from a desire to die. However, some self-harming behaviors may be
life threatening. Self-harming behaviors linked with BPD include cutting,
burning, hitting, head banging, hair pulling, and other harmful acts. People
with BPD may self-harm to help regulate their emotions, to punish themselves,
or to express their pain. They do not always see these behaviors as harmful.
Who Is At Risk?
According
to data from a subsample of participants in a national survey on mental
disorders, about 1.6 percent of adults in the United States have BPD in a given
year. BPD usually begins during adolescence or early adulthood. Some
studies suggest that early symptoms of the illness may occur during childhood.
Diagnosis
Unfortunately,
BPD is often underdiagnosed or misdiagnosed.
A
mental health professional experienced in diagnosing and treating mental
disorders—such as a psychiatrist, psychologist, clinical social worker, or
psychiatric nurse—can detect BPD based on a thorough interview and a discussion
about symptoms. A careful and thorough medical exam can help rule out other
possible causes of symptoms.
The
mental health professional may ask about symptoms and personal and family
medical histories, including any history of mental illnesses. This information
can help the mental health professional decide on the best treatment. In some
cases, co-occurring mental illnesses may have symptoms that overlap with BPD,
making it difficult to distinguish borderline personality disorder from other
mental illnesses. For example, a person may describe feelings of depression but
may not bring other symptoms to the mental health professional's attention.
Women
with BPD are more likely to have co-occurring disorders such as major
depression, anxiety disorders, or eating disorders. In men, BPD is more likely
to co-occur with disorders such as substance abuse or antisocial personality
disorder. According to the NIMH-funded National Comorbidity Survey
Replication—the largest national study to date of mental disorders in U.S.
adults—about 85 percent of people with BPD also meet the diagnostic criteria
for another mental illness. Other illnesses that often occur with BPD include
diabetes, high blood pressure, chronic back pain, arthritis, and fibromyalgia.
These conditions are associated with obesity, which is a common side effect of
the medications prescribed to treat BPD and other mental disorders.
No
single test can diagnose BPD. Scientists funded by NIMH are looking for ways to
improve diagnosis of this disorder. One study found that adults with BPD showed
excessive emotional reactions when looking at words with unpleasant meanings,
compared with healthy people. People with more severe BPD showed a more intense
emotional response than people who had less severe BPD.
Treatments
BPD is often viewed as difficult to treat.
However, recent research shows that BPD can be treated effectively, and that
many people with this illness improve over time.
BPD can be treated with psychotherapy, or
"talk" therapy. In some cases, a mental health professional may also
recommend medications to treat specific symptoms. When a person is under more
than one professional's care, it is essential for the professionals to
coordinate with one another on the treatment plan.
The treatments described below are just some of
the options that may be available to a person with BPD. However, the research
on treatments is still in very early stages. More studies are needed to
determine the effectiveness of these treatments, who may benefit the most, and how
best to deliver treatments.
Psychotherapy
Psychotherapy is usually the first treatment for
people with BPD. Current research suggests psychotherapy can relieve some
symptoms, but further studies are needed to better understand how well
psychotherapy works.
It is important that people in therapy get along
with and trust their therapist. The very nature of BPD can make it difficult
for people with this disorder to maintain this type of bond with their
therapist.
Types of psychotherapy used to treat BPD include
the following:Cognitive behavioral therapy (CBT). CBT can help
people with BPD identify and change core beliefs and/or behaviors that underlie
inaccurate perceptions of themselves and others and problems interacting with
others. CBT may help reduce a range of mood and anxiety symptoms and reduce the
number of suicidal or self-harming behaviors.
1.Dialectical
behavior therapy (DBT). This
type of therapy focuses on the concept of mindfulness, or being aware of and
attentive to the current situation. DBT teaches skills to control intense
emotions, reduces self-destructive behaviors, and improves relationships. This
therapy differs from CBT in that it seeks a balance between changing and
accepting beliefs and behaviors.
2.Schema-focused
therapy. This type of therapy
combines elements of CBT with other forms of psychotherapy that focus on
reframing schemas, or the ways people view themselves. This approach is based
on the idea that BPD stems from a dysfunctional self-image—possibly brought on
by negative childhood experiences—that affects how people react to their
environment, interact with others, and cope with problems or stress.
Therapy can be provided one-on-one between the
therapist and the patient or in a group setting. Therapist-led group sessions
may help teach people with BPD how to interact with others and how to express
themselves effectively.
One type of group therapy, Systems Training for
Emotional Predictability and Problem Solving (STEPPS), is designed as a
relatively brief treatment consisting of 20 two-hour sessions led by an
experienced social worker. Scientists funded by NIMH reported that STEPPS, when
used with other types of treatment (medications or individual psychotherapy),
can help reduce symptoms and problem behaviors of BPD, relieve symptoms of
depression, and improve quality of life. The effectiveness of this type of
therapy has not been extensively studied.
Families of people with BPD may also benefit
from therapy. The challenges of dealing with an ill relative on a daily basis
can be very stressful, and family members may unknowingly act in ways that
worsen their relative's symptoms.
Some therapies, such as DBT-family skills
training (DBT-FST), include family members in treatment sessions. These types
of programs help families develop skills to better understand and support a
relative with BPD. Other therapies, such as Family Connections, focus on the
needs of family members. More research is needed to determine the effectiveness
of family therapy in BPD. Studies with other mental disorders suggest that
including family members can help in a person's treatment.
Other types of therapy not listed in this
booklet may be helpful for some people with BPD. Therapists often adapt
psychotherapy to better meet a person's needs. Therapists may switch from one
type of therapy to another, mix techniques from different therapies, or use a
combination therapy. For more information see the NIMH website section on psychotherapy.
Some symptoms of BPD may come and go, but the
core symptoms of highly changeable moods, intense anger, and impulsiveness tend
to be more persistent. People whose symptoms improve may continue to face
issues related to co-occurring disorders, such as depression or post-traumatic
stress disorder. However, encouraging research suggests that relapse, or the
recurrence of full-blown symptoms after remission, is rare. In one study, 6
percent of people with BPD had a relapse after remission.
Medications
No medications have been approved by the U.S.
Food and Drug Administration to treat BPD. Only a few studies show that
medications are necessary or effective for people with this illness. However,
many people with BPD are treated with medications in addition to psychotherapy.
While medications do not cure BPD, some medications may be helpful in managing
specific symptoms. For some people, medications can help reduce symptoms such
as anxiety, depression, or aggression. Often, people are treated with several
medications at the same time, but there is little evidence that this practice
is necessary or effective.
Medications can cause different side effects in
different people. People who have BPD should talk with their prescribing doctor
about what to expect from a particular medication.
Other Treatments
Omega-3 fatty acids. One study done on 30 women
with BPD showed that omega-3 fatty acids may help reduce symptoms of aggression
and depression. The treatment seemed to be as well tolerated as commonly
prescribed mood stabilizers and had few side effects. Fewer women who took
omega-3 fatty acids dropped out of the study, compared to women who took a
placebo (sugar pill).
With proper treatment, many people experience
fewer or less severe symptoms. However, many factors affect the amount of time
it takes for symptoms to improve, so it is important for people with BPD to be
patient and to receive appropriate support during treatment.
Some people with BPD experience severe symptoms
and require intensive, often inpatient, care. Others may use some outpatient
treatments but never need hospitalization or emergency care. Some people who
develop this disorder may improve without any treatment.
How can I help a friend or relative who has BPD?
If you know someone who has BPD, it affects you
too. The first and most important thing you can do is help your friend or
relative get the right diagnosis and treatment. You may need to make an
appointment and go with your friend or relative to see the doctor. Encourage
him or her to stay in treatment or to seek different treatment if symptoms do
not appear to improve with the current treatment.
To help a friend or relative you can:
Offer emotional support, understanding,
patience, and encouragement—change can be difficult and frightening to people
with BPD, but it is possible for them to get better over time
·Learn about mental
disorders, including BPD, so you can understand what your friend or relative is
experiencing
·With permission from
your friend or relative, talk with his or her therapist to learn about
therapies that may involve family members, such as DBT-FST.
Never ignore comments about someone's intent or
plan to harm himself or herself or someone else. Report such comments to the
person's therapist or doctor. In urgent or potentially life-threatening
situations, you may need to call the police.
How can I help myself if I have BPD?
Taking that first step to help yourself may be
hard. It is important to realize that, although it may take some time, you can
get better with treatment.
To help yourself:
·Talk to your doctor about treatment options and
stick with treatment
·Try to maintain a stable schedule of meals and
sleep times
·Engage in mild activity or exercise to help
reduce stress
·Set realistic goals for yourself
·Break up large tasks into small ones, set some
priorities, and do what you can, as you can
·Try to spend time with other people and confide
in a trusted friend or family member
·Tell others about events or situations that may
trigger symptoms
·Expect your symptoms to improve gradually, not
immediately
·Identify and seek out comforting situations,
places, and people
·Continue to educate yourself about this
disorder.
Participate,
refer a patient or learn about results of studies in ClinicalTrials.gov ,
the NIH/National Library of Medicine's registry of federally and privately
funded clinical trials for all disease.
Find
NIH-funded studies currently recruiting participants withBPD.
