World AIDS Day Through a Mental Health Perspective

World AIDS Day is observed each year on December 1 and is an opportunity for people worldwide to unite in the fight against HIV, show their support for people living with HIV, and remember those who have died. Started in 1988, World AIDS Day was the first ever-global health day.

Mental illness is higher in individuals with HIV/AIDS

The CDC estimated that at the end of 2006, the most recent year for which national prevalence estimates are available, there were 1,106,400 adults and adolescents living with HIV infection in the United States. In 2009, the estimated rate of AIDS diagnoses in the US was 11.2 per 100,000. HIV and AIDS not only have severe physical health consequences but the majority of individuals affected by the debilitating disorder struggle with the psychological stress of their diagnosis, fueled by stigma, discrimination, anxiety, despair, and confusion. In fact, research shows a strong correlation between mental health disorders and living with HIV or AIDS, a correlation that is often overlooked. In the US, the HIV prevalence among those with a serious mental illness (2–6%) compared to the general population (0.5%) is significantly higher.

Mental illness can lead to suboptimal treatment outcomes in individuals with HIV

According to the National Institutes of Health, people with HIV have an increased risk for developing mood, anxiety, and cognitive disorders and are twice as likely to live with depression as those who do not have HIV. Among adolescents and young adults living with HIV, more than 60% of the population has some type of mental disorder. An estimated 50% of people living with HIV meet criteria for one or more mental or substance use disorders, which is associated with suboptimal HIV treatment outcomes.

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HIV/AIDS and other chronic infectious disorders such as hepatitis, herpes and syphilis result in severe social stigma, often leading to decreased self-esteem, and may eventually trigger destructive behaviors such as drug and alcohol use. HIV/AIDS requires multiple medications on a daily basis, routine monitoring from medical providers, and an immense amount of social support, not to mention the financial burden this disease can have on an individual. With all of these stressful underlying triggers, individuals are at an increased risk for developing mental health disorders. Additionally, some individuals who experience mental health problems have trouble taking their HIV treatment correctly and may miss doses, skip appointments or not eat a healthy, balanced diet.

Positive mental health is associated with improved physical health outcomes across a range of chronic illnesses, including HIV however when a negative psychological response is attached to an HIV diagnosis, it can result in disease progression, worsening stigma, loss of social support and an increase in mental health problems in those individuals. HIV/AIDS and mental health are truly intertwined.

Treating mental health disorders and HIV/AIDS

HIV/AIDS can be such a devastating physical disorder that health professionals often overlook the mental health effects it can have on an individual. The stigma associated with HIV embodied in discriminatory social structures, policy, and legislation results in a disparity between physical and mental health care services with lower accessibility, availability and quality of services. Prescribing medications, monitoring blood counts and enrolling in new treatment studies may be the only avenues a physician will offer to an individual with a new diagnosis of HIV/AIDS. However, it is important to understand the bigger picture and treat the individual from an emotional and mental health standpoint as well. Screening for signs and symptoms of depression and anxiety should be performed on a regular basis and offering support groups that aid in mental and emotional health can also help alleviate some of the stress associated with this disorder. HIV/AIDS and any other chronic medical condition can often lead to severe mental health disorders and therefore treating these disorders as if they were co-occurring disorders may benefit the individual in the long haul.

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