HIV and AIDS and Mental Health
What is HIV?
HIV, or human immunodeficiency virus, is the virus that causes AIDS (acquired immunodeficiency syndrome). HIV can be transmitted during sexual intercourse, by sharing syringes, or during pregnancy, childbirth, or breastfeeding.
HIV weakens the immune system by destroying CD4+ T cells, a type of white blood cell that is important for fighting off infections. The loss of these cells means that people living with HIV are more vulnerable to other infections and diseases.
Today, effective anti-HIV medications allow people with HIV to lead long, healthy lives. When taken as prescribed, these daily medications, called antiretroviral therapy (ART), can suppress the amount of virus in the blood to a level so low that it is undetectable by standard tests.
Why are people with HIV and AIDS at a higher risk for mental disorders?
The stress associated with living with a serious illness or condition, such as HIV, can affect a person’s mental health. People with HIV have a higher chance of developing mood, anxiety, and cognitive disorders. For example, depression is one of the most common mental health conditions faced by people with HIV.
It is important to remember that mental disorders are treatable. People who have a mental disorder can recover.
HIV and related infections can also affect the brain and the rest of the nervous system. This may change how a person thinks and behaves. Also, some medications used to treat HIV may have side effects that affect a person's mental health.
Situations that can contribute to mental health problems for anyone:
- Having trouble getting mental health services
- Experiencing a loss of social support, resulting in isolation
- Experiencing a loss of employment or worries about being able to perform at work
- Dealing with loss, including the loss of relationships or the death of loved ones
In addition, people with HIV include may also experience situations that negatively impact their mental health, such as:
- Having to tell others about an HIV diagnosis
- Managing HIV medicines and medical treatment
- Facing stigma and discrimination associated with HIV/AIDS
Understanding how living with HIV can affect mental health and knowing what resources are available can make it easier for people to manage their overall health and well-being.
What other complications can be caused by HIV?
HIV causes significant inflammation in the body. This inflammation can cause neurological complications by damaging the spinal cord and brain, which form the central nervous system.
Despite effective ART, people with HIV are still at risk for central nervous system diseases associated with HIV. These diseases can be neurological (affecting the nervous system) or neurocognitive (affecting cognition or mental processing).
Severe neurological impairments such as dementia, brain atrophy, and encephalitis (inflammation of the brain) are less common in people who use ART, compared to people with HIV who are not on ART. However, there are still less severe forms of central nervous system diseases associated with HIV.
Researchers are working to better understand how HIV affects the central nervous system. This information will be helpful to develop new treatments to improve the lives of people with HIV. Understanding which types of cells in the central nervous system are targeted by the HIV infection and how those cells are damaged may help shape efforts to prevent, treat, and cure HIV.
Research efforts also focus on understanding why HIV is harder to eliminate in some tissues in the body and what strategies might be more effective on those cells.
How can people with HIV improve their mental health?
Research shows that HIV treatment should begin as soon as possible after diagnosis to achieve the best health outcomes. Following a treatment plan, such as taking the medications prescribed by a healthcare provider, is critical for controlling and suppressing the virus.
Following the treatment plan can be difficult, but there are strategies that can help such as following a treatment plan, creating a routine, setting an alarm, and downloading a reminder app on a smartphone.
Starting ART can affect mental health in different ways. Sometimes ART can relieve anxiety because knowing that you are taking care of yourself can provide a sense of security. However, coping with the reality of living with a chronic illness like HIV can be challenging. In addition, some antiretroviral medicines may cause symptoms of depression, anxiety, and sleeplessness and may make some mental health issues worse.
For these reasons, it is important for people with HIV to talk to a healthcare provider about their mental health before starting ART. These conversations should continue throughout treatment.
People with HIV should talk with their provider about any changes in their mental health, such as thinking or how they feel about themselves and life in general. People with HIV should also discuss any alcohol or substance use with their provider.
People with HIV should also tell their healthcare provider about any over-the-counter or prescribed medications they may be taking, including any mental health medications, because some of these drugs may interact with antiretroviral medications. Learn tips for talking with a healthcare provider about your mental health.
National Institute of Mental Health. (2022, November). HIV and AIDS and Mental Health. U.S. Department of Health and Human Services, National Institutes of Health. Retrieved March 22, 2023, from https://www.nimh.nih.gov/health/topics/eating-disorders