Why is psychiatry involved in HIV care?

Mental and neurological disorders have an intertwined relationship with HIV and AIDS, yet sadly are often overlooked when HIV interventions are planned and implemented. Several important aspects of HIV care and treatment place psychiatrists at the forefront of this epidemic, including: 

·        psychiatric disorders (including substance use) can increase an individual’s risk of acquiring sexually transmitted diseases, including HIV;

·        pre-existing mental disorders (including substance use) can predate and/or complicate HIV-related illness;

·        neuropsychiatric complications and psychiatric illness can affect adherence to antiretroviral therapy regimens;

·        new antiretroviral treatments and combination therapies can affect the CNS and/or contribute to the development of psychiatric side effects/symptoms;

·        individuals with waning immunity and high viral loads may be at particular risk for the HIV-related CNS complications that can cause acute mental status changes;

·        the proportion of mental health and/or substance abuse disorders among people living with HIV/AIDS is nearly 5 times greater than the proportion found in the general population;

·        persons living with a severe mental illness are disproportionately vulnerable (as high as 23%) to infection with HIV and other sexually transmitted diseases;

·        psychiatric syndromes can be especially challenging to recognize and accurately diagnose in the medically ill; and

·        as HIV/AIDS becomes increasingly a chronic disorder with the improvement of treatments and longer survival times, the need for comprehensive psychiatric care and services is expected to rise.