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Interview with Dr Bartosz Szetela - Elements of humanisation in HIV/AIDS systemic solutions

10 December 2022

Welcome. My guest is Mr Bartosz Trela, a specialist in infectious diseases. Doctor, for a good few years now, since 2005, you have been taking care of and treating patients with HIV and AIDS. Doctor, is the Wrocław Health Centre, i.e. the All Saints' Outpatient Clinic, located down the street?

All Saints' Outpatient Clinic has adopted a new name that is more recognisable to internet users. From now on it will be known as the All Saints Outpatient Clinic in All Saints Street. We hope that this change will help us to better serve our patients and make it easier for them to find our facility.

I am a doctor from the Medical University of Wrocław, and I am very happy to talk to you about an important issue: the relationship between a doctor and a patient suffering from AIDS or living with HIV. As a doctor with many years of experience in this field, I believe that the most important thing in this relationship is to build a humanistic and wholesome bond between the patient and the doctor.

In the case of patients with AIDS or living with HIV, the doctor must remember that this disease not only affects their physical health, but also their mental and emotional health. Therefore, it is important for the doctor to be empathetic and listen to the patient's needs, both those related to their illness and their personal needs. With this approach, the patient will be able to talk openly about their concerns and difficulties and the doctor will be able to help them more effectively.

In addition, the doctor should provide the patient with all the necessary information about the disease and its treatment, so that the patient can make informed and thoughtful decisions about his or her health. It is also a good idea to ensure that the patient has access to various forms of support, such as support groups for people with HIV or AIDS, psychological counselling and other services that can help them cope with the disease and its impact on their daily lives.

Doctors have a difficult task, especially when dealing with HIV patients. In the early days of the epidemic, there was a shortage of drugs and most patients died after six months of diagnosis. People infected with the virus were excluded by society, leading to self-stigmatisation. Some were excluded because of the route of infection, for example through intravenous drugs or homosexual contact. In such a situation, it was difficult to work with patients if doctors treated them only as 'clerks' responsible for administering drugs and making a diagnosis.

As a psychologist or therapist, accompanying the patient is very important. When a patient comes with a problem, it is our job to ask how we can help. In this way, we set ourselves up as a person who wants to help and is ready to help the patient in the way he or she needs that help. It is important to be open to the patient's needs and to adapt our help to their individual needs.

The issue of the excluded patient is very important and requires a special predisposition on the part of the doctor caring for him or her. The patient suffers both from his illness and from feelings of guilt and exclusion. The doctor must be equipped with not only professional skills, but also 'soft' skills such as empathy and understanding of the patient's needs. To work with such patients, the doctor should possess qualities such as empathy, patience and the ability to build rapport with the patient.

As you can see, the theme of the article is about being a doctor and empathy in the relationship with the patient. A doctor must be able to listen to the patient, support them and help them, regardless of their personal views and beliefs. Empathy in a doctor's work is important, but it can be emotionally costly. Therefore, it is important that doctors have the opportunity to benefit from supervision, i.e. support from other doctors in dealing with patients' emotions and difficult situations.

Undergoing therapy can be difficult, but it can also bring many benefits. Some people feel lost and need support to cope with the problems they are facing. Therapy can help them to better understand themselves and their emotions, and teach them how to deal with their difficulties in a healthy and effective way.

To get the most out of therapy, it is important to have the right therapist who is able to understand the patient's needs and feelings. Some people opt for supervision, which is an analysis of the therapist's work and the conversations held in the office, to make sure that the therapy is working effectively and in line with professional ethics.

Therapy can be expensive, but for many people it is an investment in their health and wellbeing that can change their lives for the better. If you feel you need support, consider seeking therapy. It can be the key to understanding yourself better and coping with your difficulties.

Infectious diseases are a major challenge for our community, and there are fewer specialists in this field than would be needed. It is particularly difficult to find empathetic doctors who can navigate the intimate areas of patients' lives. HIV and AIDS are just examples of diseases that require the humanisation of medicine. It is worth emphasising that doctors fighting these diseases have to deal with many difficulties, including emotional barriers."

Talking to a patient about intimate issues can be difficult, both for the doctor and the patient. In order to establish a good relationship and get the information needed, it is important that the doctor prepares appropriate questions and diagrams to guide the conversation. It is important that the questions are understandable to the patient, but at the same time not invasive. Once the patient starts answering the questions, the doctor should refer to the answers given in order to better understand the patient's needs and how best to help them.

Sexual health is an important part of overall human health. Having intercourse with different people, both men and women, is a natural human need. This is why AIDS researchers in Poland are guiding, following US guidelines, that doctors should talk to patients about their sex life. Just as important is the health of the heart or liver, so questions about who the patient is cohabiting with and how much such contact there has been are crucial. Doctors should do this in a sensitive way, without judging the patient, which requires a certain skill acquired in practice. Unfortunately, this is not taught in medical studies, which leads to bad relationships between doctors and patients. Therefore, it is important that doctors and nurses learn this skill in practice to better protect the sexual health of their patients.

The set of questions that the patient is asked at the beginning of the medical interview is specific to each case. This is important because it allows the doctor to obtain detailed information about the patient's condition and, based on this, make a proper diagnosis. Asking the right questions also helps the doctor to determine what additional examinations and tests are needed to make an accurate diagnosis. It is worth remembering that the more information the doctor has, the better he is able to help the patient.

At the counselling centre, we provide patients with reliable and trustworthy information about sexually transmitted infections, including HIV and HCV. Through our conversation, patients learn about the symptoms and treatment of these diseases. Also, we discuss with them the relationships they are in to make sure that the patient's partners or children are safe and not infected. We also carry out investigations to start treatment if necessary. All this is done in an atmosphere of understanding and support, so that patients feel free to ask questions about their health and those close to them.

Talk about the ability to talk to patients in a normal and stress-free way. It is important to practice the questions at the beginning so that later on they become natural and the patient does not associate them with something embarrassing. Questions about a rash or pain behind the sternum should be treated in the same way as any other normal medical question. By taking this approach, the doctor can build a good relationship with the patient and make it easier for them to open up about their health.

A well-run relationship with patients can help to increase their trust in the doctor. Building a good relationship with patients is important as it helps to create a friendly and comfortable atmosphere that can make patients feel safe and reduce the stress of visiting the doctor.

During visits, it is useful to focus on building a relationship based on trust and respect. It is important to listen to the patient carefully and explain any doubts or concerns they may have. The doctor should also be open to the patient's questions and answer them in a way that is clear and understandable to the patient.

In addition, keeping medical records accurate and up-to-date can also contribute to patient confidence. This allows the doctor to track the patient's progress and better adapt the treatment plan to the patient's needs.

In summary, building a good relationship with patients is key to providing them with appropriate medical care and increasing their trust in the doctor. It is important that the doctor is open to the patient's questions, listens carefully to them and keeps medical records accurate and up-to-date.

The epidemic of HIV and other sexually transmitted diseases is a serious problem worldwide. People infected with such diseases often need support and specialist advice, but they do not always have a place to seek it. It is therefore important that access to professional medical care is easy and stress-free for them. It is worth remembering that every patient deserves to be treated impartially and with respect, no matter what problems they face.

As professionals involved in the health care of patients, we are committed to providing high quality advice and support. Patients often come to us with difficult, often socially unacceptable, behaviours or attitudes. Our job is to provide them with the advice they need, which creates trust and confidence in them that they can get help here. However, our activities also involve responsibility for patients. Some of them are happy to shift this responsibility to us, so we need to be vigilant and pay attention to developing addictions or dangers in an appropriate way. All this should be done in a spirit of dialogue and motivation to ask questions and exercise appropriate caution.

Patients often develop close relationships with doctors, which on the one hand can be beneficial, but on the other hand requires caution and vigilance. It is important to keep an appropriate distance and to take care of the patient's welfare and the protection of his or her privacy. Doctors should be aware of the importance of these issues and take appropriate measures to preserve them.

Improve the following text to make it a quality article for internet users

Doctor, you will admit that over these last few years the odium has been taken off HIV, AIDS a little bit, that it's not like that anymore. There is not such a social ostracism towards these people. But there is the problem of, I think, increasing infections of other sexually transmitted infections. What does that look like in practice?

The text above is chaotic and inaccessible to the audience. In order to improve it, it should start by organising the information and removing unnecessary repetition.

In Poland, there is such a thing as comprehensive outpatient specialised care for people with HIV. It is better than family care because patients can benefit from a wider range of tests and diagnostics and receive them free of charge. Family care also has its advantages, such as availability in the immediate area or the possibility to visit regardless of the clinic's schedule.

However, it is important to note that patients often come to GPs for other illnesses and situations, such as a broken leg or the need to visit the dentist. In such cases, they may feel anxious about having to inform their doctors about their HIV infection

A patient with HIV requires enhanced care and often needs the additional support of being able to contact a doctor or caregiver. In these situations, sometimes patients are given telephones for our counselling service so that they feel safe and know that they can contact us if needed. While this option can sometimes be abused, usually patients are aware that this is not a privilege but a necessity in urgent and important situations for their health. HIV care has changed and requires special attention.

In the past, many people were diagnosed with HIV infection at the AIDS stage, which meant profound immunodeficiency. Such patients often required intensive care and treatment for long periods of time and were exposed to various ailments, such as fever. Today, thanks to early diagnosis of HIV, fewer than 50% people in Poland and Europe are in the AIDS stage. However, there is still a group of people who are diagnosed with HIV infection at a late stage, which is associated with immunodeficiency and the risk of serious complications. Fortunately, thanks to advances in HIV treatment, people with early diagnosis often do not suffer from symptoms and can lead ordinary lives.

Carrying out care for HIV-infected patients requires a special approach because of their individual needs. It is undisputed that more than 90% HIV infections are sexually transmitted, so it is important that health care professionals do not avoid this topic. It is important to provide complete care to patients, which requires trust from patients. In HIV clinics, we have not had problems with people denying the epidemic or not wanting to be vaccinated. We talk to them and convince them that we can be trusted and we work for them. As a result, the percentage of unvaccinated people in our counselling centres is much lower than in the country as a whole, where only half of people get vaccinated.

The condom is the primary method of HIV prevention, but there is also exposure prevention, available since 2012 in Poland. Since 2017, when the drug became cheaper thanks to the advent of genetics, it has been possible to use this method on a mass scale. If it was targeted at people at high risk of HIV infection, we could virtually eliminate new HIV infections, or at least early infections, within a few years.

Exposure prophylaxis consists of taking one tablet a day. There is also an ad hoc prophylaxis option that protects against HIV infection 100 per cent of the time when there is a risk of infection, such as sex without a condom. This is an amazing tool that could change the future in the fight against HIV.

I am sorry, but this text lacks essential information to be considered a quality article for internet users. First of all, it is not clear what preventive method is being referred to and what its effects are in Poland and worldwide. Furthermore, the text contains many ambiguities and grammatical errors.

In order to write a quality article for internet users, it is first necessary to identify the topic and the purpose of the article. Then, clear and reliable information on the topic should be presented, based on facts and reliable sources. The text should be organised logically, taking into account the sequence of events and the individual steps that lead to the conclusions and lessons learned. In addition, care should be taken to ensure correct grammar and style of language so that the text can be read and understood by readers.

In Poland, the number of HIV tests has increased from 6 per 1 000 inhabitants per year to 11 per 1 000 inhabitants per year. This is an improvement on the situation in Europe, where an average of 60 tests per 1 000 inhabitants per year are carried out. HIV treatment is important both for the health of patients and to prevent further spread of the virus. After six months of treatment, the virus becomes undetectable, meaning that the person is no longer infectious. This situation contributes to an improved quality of life for people with HIV, who often feel excluded and branded. Treatment enables them to function normally in society.

HIV and AIDS are no longer as condemned by society as they once were. Many people are living with these diseases and enjoying their lives to the fullest, thanks to the medicines and social support now available.

Unfortunately, there is still the problem of an increasing number of infections with other sexually transmitted diseases such as chlamydia, gonorrhoea and HPV. It is important to pay attention to your sexual health and undergo regular examinations and use appropriate precautions, such as condoms, to minimise the risk of infection.

In addition, it is important to reinforce sexual health knowledge and awareness and take preventive measures to reduce STI infections. It is also worth seeking the help of a specialist if you have any symptoms or concerns about your sexual health.

The odium or social ostracism towards HIV is definitely decreasing, especially in large cities and among younger generations. More and more people are informing their relatives about their disease and even taking part in tests with the preventive vaccine. However, in small towns and among the older generations, this change is not so visible. Sexually transmitted infections are still seen as something shameful and stigmatising. It is important to consider how to change this situation through better education, prevention and more frequent diagnosis.

Patients living with HIV and other sexually transmitted infections, as well as patients on antiretroviral therapy and pre-exposure prophylaxis, come to our HIV clinics. Whether they are street patients or their partners or partners have recommended that they visit us, we always try to help them.

For years, HIV was highly stigmatised and many patients locked themselves away, avoiding telling their partners about their condition. Fortunately, today the situation has changed and more and more patients are openly talking about their infection and encouraging their partners to see a specialist.

This is very encouraging as it shows that people are becoming more aware of their health and are not afraid to disclose their HIV status. By doing so, we can better help them fight the disease and prevent its spread.

The stigma associated with STDs is still present in our society and this needs to change. HIV is perceived differently by the younger generation, and in big cities, STDs have taken over a bit from what used to be associated with HIV. People are ashamed of STDs, which reminds them of the shame associated with syphilis in 19th century France. Shame is also associated with other bacterial diseases such as angina. Sexuality is still a taboo subject in Poland.

A better version of this text would be one in which the author focused on one particular aspect of working with chronically ill patients, such as diabetes or HIV. Such a text would need to discuss the problem of stigma that affects these types of patients, as well as ways to deal with this problem when working with patients. It would also be important to highlight the need for humanisation when working with chronically ill patients and effective methods of communication with them to help build a positive and trusting relationship.