Explaining HAND, depression treatment, and ART interactions — CASC communication station

Station brief

Format. Communication station, approximately 7–10 minutes after reading time. You are the psychiatry registrar in the HIV clinic. Patient and sister attend.^[5][7]

Candidate instructions. Explain that depression is common and treatable in HIV and can worsen missed ART doses. Distinguish possible HIV-related cognitive changes (HAND spectrum) from depression without alarming falsely. Address efavirenz nightmares and the plan to work with the HIV team on regimen choice. Explain that some psychiatric medicines interact with ART boosters — you will choose carefully with pharmacy — not that all psychiatric treatment is impossible. Address shame/stigma compassionately. Take death wishes seriously with a safety plan. Strongly advise against stopping ART without specialist replacement.^{[1][2][3][4][6]}