By Dr. David Woo - March 2, 2023

Mental health problems do not necessarily happen in isolation. They can also arise in relation to physical diseases. In this article, we look at how HIV/AIDs can affect mental health.

What Is HIV? Is It Different From AIDS?

Although most people associate these two acronyms with each other, many don’t understand how they are related. 

• Human Immunodeficiency Virus (HIV) is a virus that causes the deterioration of the immune system. It attacks CD4+ T cells, the white blood cells that play a key role in combating infections. Fewer of these cells results in a greater vulnerability to disease.
• Acquired Immunodeficiency Syndrome (AIDS) is a condition that develops as the result of an advanced HIV infection that has caused extensive damage to the immune system. Also called HIV stage 3, its symptoms are related to other subsequent infections one can contract as a result of the body’s weakened defenses.

HIV can never be completely eliminated by the immune system, and is transmitted via bodily fluids during sexual intercourse, pregnancy, breastfeeding, or sharing syringes.

While it is not possible to have AIDs without HIV, many individuals with HIV never contract AIDs. Modern treatments such as antiretroviral therapy (ART) are available to suppress HIV and allow patients to live long, healthy lives (1).

Mental Health Risks Associated With HIV and AIDS

Stress

Living with a serious illness like HIV is stressful and can impact one’s mental health. Individuals with HIV/AIDs have a greater probability of mood disorders such as anxiety and depression, the latter being especially prevalent at 31%. (2) 

HIV patients must contend with stressful situations such as:

• Social stigma surrounding HIV/AIDs and possible discrimination
• Fear of having to disclose HIV-positive status to others
• Managing medication and treatment schedules

Damage to the Brain

HIV and associated infections can also physically impact the brain, negatively affecting a person’s thoughts and behavior. The severe inflammation caused by HIV may damage the brain and the spinal cord, causing neurological damage such as pain and movement problems and/or neurocognitive damage like mental processing, memory and concentration. An estimated 50% of people with HIV develop neurological complications. (3)

Because thoughts and emotions arise from electrochemical activity in the brain, the damage caused by inflammation can also bring about or compound mental health disorders. Inflammation of the brain (encephalitis), dementia, and brain atrophy are less common among HIV patients undergoing treatment.

Effects of Medication

Simply starting ART can relieve symptoms of anxiety, but some patients on antiretroviral medicines may experience side effects such as depression, anxiety, and sleeplessness. Anxiety has also been linked to poor adherence to the medication schedule. (4)

HIV patients should consult their healthcare provider before starting ART, and the provider should monitor the patient’s mental state throughout treatment. Patients should also disclose any use of alcohol, drugs, or other medications (including mental health medicines) to avoid dangerous interactions with antiretrovirals.

Mental Health Treatment for People With HIV

People with an HIV diagnosis will find it helpful to understand how it may impact their mental health going forward. Finding appropriate resources, support groups, and treatment options early on is crucial to maintaining mental wellness. 

Treatment options include talk therapy, pharmaceutical medications, and transcranial magnetic stimulation (TMS), a drug-free alternative effective against depression and anxiety.

To make an appointment with a licensed healthcare professional at Madison Avenue TMS & Psychiatry, contact us online or call (212) 731-2033.

Resources:

1. HIV Treatment: The Basics. HIV Info at NIH.org. August 16, 2021. Link. Accessed February 6, 2023.
2. Rezaei S, Ahmadi S, Rahmati J, Hosseinifard H, Dehnad A, Aryankhesal A, Shabaninejad H, Ghasemyani S, Alihosseini S, Bragazzi NL, Raoofi S, Kiaee ZM, Ghashghaee A. Global prevalence of depression in HIV/AIDS: a systematic review and meta-analysis. BMJ Support Palliat Care. 2019 Dec;9(4):404-412. Link. Accessed January 24, 2023.
3. Power C, Boissé L, Rourke S, Gill MJ. NeuroAIDS: an evolving epidemic. Can J Neurol Sci. 2009 May;36(3):285-95. Link. Accessed January 24, 2023.
4. Wykowski J, Kemp CG, Velloza J, Rao D, Drain PK. Associations Between Anxiety and Adherence to Antiretroviral Medications in Low- and Middle-Income Countries: A Systematic Review and Meta-analysis. AIDS Behav. 2019 Aug;23(8):2059-2071. Link. Accessed January 24, 2023.  

Dr. David Woo

Dr. Woo has been seeing patients in private practice since 2002, always with the goals of combining evidence-based medicine with psychodynamic psychotherapy and collaborating with other mental health professionals to ensure the best possible outcomes for his patients. He has been certified to administer TMS at his practice since 2017. His greatest clinical interests include helping patients suffering from depression, anxiety, and obsessive compulsive disorder.