By Gloria Mpundu Nursing C'22
The number of people diagnosed with mental health disorders has been increasing over the years though there has been a dramatic increase since the pandemic started. Certain communities have a higher risk of developing mental health disorders. This includes marginalized communities and those living with chronic conditions, like HIV/AIDS.
People living with HIV are disproportionately affected by mental health disorders, particularly depression, due to social isolation, discrimination, stigma and the overall stress associated with adapting and living with a chronic infectious disease. Additionally, HIV can significantly damage the central nervous system causing neurological and neurocognitive impairments such as dementia, brain atrophy and encephalitis, which can further increase these individuals’ risk for mood, anxiety and cognitive disorders, especially those who do not adhere to antiretroviral therapy. Although the introduction of antiretroviral therapy has provided a sense of security to individuals living with HIV because of its proven abilities to improve their quality of life and life expectancy, these medications can cause depressive and anxiety symptoms.
Simultaneously, people living with mental health illness are at a higher risk of contracting HIV. In fact, mental health issues increase the risk of HIV acquisition by four to ten times and HIV prevalence is higher among those with serious mental disorders. The risk of acquiring HIV infection among individuals with mental health disorders is exacerbated by the increased probability of engaging in unsafe sexual practices such as having multiple sexual partners, substance abuse before sex and inconsistent condom use.
Unfortunately, this complex bidirectional relationship between HIV and mental health disorders affects the health outcomes of the affected individuals, especially due to the stigma associated with both health conditions. Individuals with both HIV and mental health disorders experience poorer health outcomes compared to the general population. This is because mental health impairment associated with mental health illness such as depression, anxiety or substance use disorder can interfere with people’s ability to seek care and adhere to HIV antiretroviral therapy. Consequently, non-adherence to HIV treatment plans can lead to lower rates of viral suppression, progression to AIDS, worsening opportunity infections and increased mortality rates.
As the fight to end the HIV epidemic continues, it is imperative to take into account the fact that HIV and mental illness are intertwined and should be addressed concurrently by integrating mental health and HIV care in healthcare facilities.
As the fight to end the HIV epidemic continues, it is imperative to take into account the fact that HIV and mental illness are intertwined and should be addressed concurrently by integrating mental health and HIV care in healthcare facilities. This can be achieved by increasing the number of health centers that serve those with both mental health illnesses and HIV, increasing mental health screening among those who are newly diagnosed with HIV or those who have been living with HIV and raising awareness about HIV in mental health clinics.