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Now on its third site (built on the land where the original Victorian hospital stood), the hospital in its latest incarnation was officially opened at the end of 2015 by Prince Harry, continuing in his mother’s footsteps to raise awareness and dispel stigma.But, during this time, it has gone from being an NHS hospital to a charitable one, an indicator of the times.Although it was a bold campaign that got people talking about HIV/AIDS and almost certainly saved lives, it also generated a backlash of fear and stigma, leading to myths that HIV could be ‘caught’ by sitting on a public toilet seat or shaking someone’s hand.
Now HIV is managed in much the same way as any other long-term health condition, says Nelson.Before the use of antiretroviral drugs, about 20-30% of people with advanced HIV infection previously developed dementia. Treatment with a combination of at least three antiretroviral drugs often prevents cognitive impairments worsening and, for many people, can reverse the cognitive damage caused by HIV.Rehabilitation programmes may also help people with HAND to re-learn skills.“HIV is not a one size fits all, especially in the area of cognitive impairment which can produce such varied responses in patients.” Advances in antiretroviral drugs has led Mildmay to change its focus from end-of-life care to specialised rehabilitation.It is now Europe’s only centre dedicated to rehabilitating people living with HIV-associated neurocognitive disorder (see box).
All activities work to promote skills including fine and gross motor skills; hand-eye co-ordination; literacy; orientation; social interaction; memory; decision-making and planning; road safety; money management; problem solving; executive function; food preparation; speech and language.