Phoenix Rising HIV/AIDS Re-entry Project

Health

	Your health is a major factor in determining whether you are ready for re-entry. The options that are available and the choices you make will be influenced by whether your health is generally improving, steady, or declining; what symptoms you experience and what you can do to maintain or improve your health. The questions in this section will help you to do the following:
		Evaluate your physical and mental health.
		Consider how you could be affected by a work or school schedule.
		Identify strategies to keep you healthy through the re-entry process.
	If you need assistance in answering any question, ask your doctor, case manager, family member, or partner to help you. The following four pages are available for printing. Click on the title of any page at right to download that page.
		Physical Health
		Drug Regimen
		Energy Level and Physical Activity
		Mental Health

Download the Questionnaire (four pages).

	Physical Health HIV/AIDS symptoms can dramatically affect your stamina, alertness, and overall ability to work or study. Paying close attention to how symptoms affect you can help you develop a work or school schedule that is manageable and promotes your continued health.
		Current viral load: _______ increased/decreased since last blood test.
		T-cell count: _______ increased/decreased since last blood test.
		If you are HIV+ and symptomatic, check all symptoms that you have:
		_____	Fatigue	_____	Memory Loss
		_____	Night Sweats	_____	Poor Concentration
		_____	Poor Stamina	_____	Weight Loss
		Other:
		If you have AIDS, check all symptoms that you have:
		_____	Low T-cell count	_____	Wasting syndrome
		_____	Loss of appetite	_____	Recurrent Opportunistic Infections
		Other:
		Do these conditions create limitations for you? If yes, describe them.
		Describe how you could maintain or improve your health while working or going to school:
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	Drug Regimen We are fortunate to have drug regimens that fight the virus, treat the symptoms of HIV/AIDS, and improve our health. The regimens can be complicated and difficult to follow, especially with a busy schedule. The more awareness you have about your drug regimen and side effects, the easier it will be for you to create a work or school schedule that makes adherence easier.
		Are you experiencing side effects from the medications? If yes, describe what they are:
		What concerns do you have about maintaining your drug regimen and/or dealing with side effects while working or going to school?
		Describe what you could do to maintain your drug regimen and/or deal with side effects while at work or school:
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Energy Level and Physical Activity

Being aware of your energy level and when you feel best can help you be active without pushing yourself too hard and help you to schedule challenging activities for the time when you are feeling your best.

How would you describe your general energy level?

_____

High

_____

Normal

_____

Low

_____

Fatigued

What are your concerns about maintaining your energy while working or going to school?

When are you most active without becoming overly tired?

_____

Morning

_____

Afternoon

_____

Evening

Do you require naps to rejuvenate? If so, when:

_____

Morning

_____

Afternoon

_____

Evening

Are you physically stable and able to engage in new activities?

_____

Yes

_____

Do you have difficulty performing some physical activities? If so, check all that apply:

	_____	Walking	_____	Stooping/bending	_____	Standing
	_____	Sitting	_____	Lifting	_____	Climbing

		Do you think physical limitations will be an obstacle to your going to work or school? If yes, describe:
		What could you do and what resources would you need to overcome these obstacles?
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Mental Health

The symptoms of HIV/AIDS can impair cognitive abilities and create emotional swings, including anxiety and depression. If you experience those effects, you can work around them in your re-entry plan so that they aren't a barrier to your goals.

Has HIV affected your cognitive abilities? Check all that apply.

_____	Memory	_____	Ability to concentrate	_____	Decision making
_____	Attention span	_____	Communication skills
Other:

How are you coping with these effects? Check all that apply.

_____	Make lists	_____	Keep a schedule or routine
_____	Take shorter breaks	_____	Re-check my work
_____	Take extra time to complete tasks
Other:

Do you currently have symptoms of depression? If yes, check all that apply.

_____	Increased or decreased sleep	_____	Changes in appetite
_____	Feelings of hopelessness	_____	Lack of pleasure
_____	Weight gain or loss, not HIV-related
Other:

Do you currently have symptoms of anxiety? If yes, check all that apply.

_____	Increased worry	_____	Poor appetite
_____	Difficulty concentrating	_____	Irritability
_____	Inappropriate feelings of guilt	_____	Fatigue
Other:

How do you deal with anxiety and depression? Check all that apply.

_____	Rest	_____	Deal with my frustration
_____	Let go of my anger	_____	Address my fears
_____	Have a sense of the future	_____	Shut down/withdraw
_____	Seek outside help, i.e., therapy, support groups, etc.
Other:

Describe what you can do and what resources you might need to address the above symptoms.

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