The Interaction of HIV With Mental Health in the Modern Antiretroviral Therapy Era

Abstract

People with HIV (PWH) receiving effective antiretroviral therapy (ART) continue to display residual immune dysregulation that amplifies the risk for neuropsychiatric comorbidities. At the same time, PWH commonly experience intersectional stigma and other psychosocial stressors that are linked to neuroendocrine stress responses, potentiate residual immune dysregulation, and alter other biobehavioral processes relevant to health outcomes. This special issue of Psychosomatic Medicine seeks to advance our understanding of the intersection of HIV with mental health in the modern ART era. Several articles cover topics related to the prevalence and treatment of psychiatric comorbidities among PWH such as depression, suicidality, and substance use disorders. Other articles delineate biobehavioral mechanisms relevant to mental health in PWH such as inflammation, immune activation, neuroendocrine signaling, cellular aging, the microbiome-gut-brain axis, and neurobehavioral processes. Collectively, the articles in this special issue highlight the continued importance of biobehavioral and neurobehavioral mental health research in the modern ART era.

HIV associated psychiatric comorbidity among attendees at a tertiary hospital, North-Eastern Nigeria

“… 3 On the one hand, having a preexisting mental health disorder might be a contributory factor to contracting the virus, through engaging in risky behaviour such as injection drug use or engaging in risky sexual behaviour in those who have substance use disorders. 3 This increased risk of contracting HIV has been reported among individuals with substance use disorder, 9 while Wandel et al showed that the prevalence of substance use disorders was high in HIV positive persons even before the diagnosis of HIV. 10 Risky behaviour can also occur in those who are disinhibited in certain affective disorders like mania.…”

“…They potentiate residual immune dysregulation and alter other biobehavioural processes relevant to health outcomes. 9 Suicide ideation is also common among PLWHA and it is very important to do a risk assessment. 2 A systematic review and meta-regression analysis by Tsai et al revealed a pooled prevalence estimate of suicidal ideation, attempted suicide and deaths by suicide of 22.3%, 9.6% and 1.7%, respectively.…”

“…There is a bidirectional relationship between a positive HIV status and mental health disorders, 6 , 8 , 9 with neuroinflammatory and certain stress-related factors playing contributory roles. 3 On the one hand, having a preexisting mental health disorder might be a contributory factor to contracting the virus, through engaging in risky behaviour such as injection drug use or engaging in risky sexual behaviour in those who have substance use disorders.…”

“…

There is a bidirectional relationship between a positive HIV status and mental health disorders, 6,8,9 with neuroinflammatory and certain stress-related factors playing contributory roles. 3 On the one Background: There are a wide range of neuropsychiatric conditions associated with human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS).

…”

Global trends in depression among patients living with HIV: A bibliometric analysis

“…Since the widespread promotion of antiretroviral therapy (ART), a large percentage of patients living with HIV (PLWH) have a lifespan comparable to that of uninfected individuals ( Kirtane et al, 2018 ). Despite receiving effective ART, PLWH continue to be plagued by residual immune dysregulation, which increases their risk for neuropsychiatric comorbidities ( Carrico et al, 2022 ). Depression is one of the most common comorbidities among adult HIV-positive individuals, with prevalence of ~20–40% ( Pence et al, 2018 ).…”