Spotlight on Mental Health and HIV

After initial exposure to HIV, brain functioning may change, explains the American Psychiatric Association. HIV-associated infections, known as opportunistic infections, can impact the production of neurotransmitters. Meanwhile, the risk for developing dementia, anxiety and mood disorders increases. Yet, clients may fail to recognize this connection. To improve community health, service providers need to understand how HIV relates to mental health disorders.


HIV and Anxiety

Depression is “one of the most common mental health conditions that people living with HIV” possess, asserts In addition to the common symptoms of depression, those with HIV may experience severe anxiety.

For example, anxiety can arise from failure to have money to pay for HIV treatment, difficulty obtaining a treating provider and problems when filing for government benefits.

Each situation directly increases a person’s stress, which further heightens the risk for developing anxiety and depression. Moreover, men who have sex with men (MSM), which includes gay and bisexual men, have a greater risk of contracting HIV than any other affected group, reports the Centers for Disease Control and Prevention (CDC).

Those with HIV may experience problems in their ability to obtain care for HIV. These problems include the following:

  • Homophobia.
  • Lack of access to medical or support services.
  • Concerns about confidentiality.
  • Fear of termination of employment.
  • Discrimination and stigma.


HIV and Addiction

HIV and addiction are two sides of the same coin. Substance abuse, which includes alcohol abuse, results in lowered inhibitions. Therefore, those under the influence of drugs or alcohol may be more likely to engage in unprotected sexual activity. Those abusing IV drugs and sharing needles are also at an increased risk for contracting HIV through a nonsexual means. In other words, a person may use a needle that an HIV-positive individual previously used and contract the virus.

Addiction plays an important role in the progression of HIV. Substance abuse leads to lessened functioning of bodily systems, which become more susceptible to opportunistic infections. Cardiovascular function decreases, the lungs become weak and the brain grows dependent on the presence of the substance. As the addiction grows, a person is more willing to go to any means necessary to obtain the substance.

With approximately 12.8 percent of those with HIV unaware of their infection, the risk for spreading the disease among those with addiction is dramatically increased. For example, one person who uses IV drugs has unprotected sex with an HIV-positive individual. Assuming he or she contracts the virus, each subsequent partner is exposed to virus. In essence, the only way to stop the spread of HIV in this situation is treatment for addiction.


Other Ways to Prevent Worsening of HIV and Mental Health Status

While HIV and mental health are related, those with and without HIV can reduce their risk of developing mental health disorders. Moreover, those with a mental health disorder can reduce the risk for contracting HIV by adhering to the same recommendations, which include the following:

  1. Maintain a healthy diet. A healthy diet helps to curb anxiety, depression and other mental health disorder. It reduces lethargy and increases the responsiveness of the immune system.
  2. Consider starting PrEP, and use condoms. Those who are at an increased risk for HIV, such as MSM, should speak with their appropriate community health provider about starting proactive treatment against HIV before infection. Use of condoms lowers the risk for contracting the virus as well.
  3. Get regular care for mental health. Identifying mental health disorders early is critical to obtaining treatment before they become severe. Those with HIV should speak with a social worker about options for seeing a psychologist or psychiatrist. Even if a problem has not yet arisen, speaking to a professional reduces the risk of developing anxiety or depression.
  4. Exercise. Exercise lowers risk for cardiovascular disease and triggers the release of endorphins.
  5. Get help with smoking cessation. Smoking weakens the immune system, making HIV prognosis more difficult.
  6. Limit alcohol consumption. Those with HIV are not forbidden to drink occasionally. However, excessive drinking, such as heavy or binge drinking, should be avoided. Those with an alcohol use disorder should obtain treatment from a qualified center or community health program.
  7. See a primary care physician. The PCP is responsible for monitoring overall health, and he or she can identify other problems that may arise from HIV infection or mental health deterioration. For example, cholesterol, blood pressure and cancer screenings should be conducted regularly by the PCP.
  8. Understand HIV-infection rates by race or ethnicity. Race and ethnicity play significant roles in the transmission of HIV as well. African Americans suffer from the most severe burden of HIV, followed by Hispanics and Latinos, explains the CDC.


Final Thoughts

Imagine what it is like to hear those words, “Your HIV test is positive.” The fear and panic sets in, and you start wonder how much time you have left. Regardless of the advancements of medicine, HIV is one of the scariest things a person can learn to live with. Now, imagine how it would feel to those who do not anything about the virus.

It is not an easy task. Living with HIV is hard, but it is easy to feel alone, frightened and stressed and turn to alcohol, drugs and risky behaviors to cope.

Not considering how HIV impacts mental health could lead to failure to take medications or see the treating provider. However, community health providers, such as social workers, screening centers, PCPs and addiction service providers, can help those with HIV control the disease.

Since HIV retains its stigma of the past, it is up to you to start the conversation with your clients, your family, your friends and everyone else. In fact, when was the last time you were tested for HIV? Even you could have it and not know it.

Jason Vanover

Working in health care since 2005, Jason's body of experience encompasses dozens of care settings, including Senior care, psychiatric facilities, nonprofit health service centers, group homes for those with developmental disabilities and beyond. Jason understands the need to tailor his skills to each setting to encourage the best treatment outcomes and promote an inclusive, healing environment.

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