Living with HIV not only takes a toll on the body but on mental health too. AIDS (acquired immune deficiency syndrome) is caused by the human immunodeficiency virus (HIV), which can be spread through sexual contact, the sharing of needles or genital body fluids, and even before birth through breastfeeding.
HIV reduces immunity by eliminating CD4+ T cells, which play a key role in fending off infections. People with HIV are more prone to contracting other infections and disorders as a result of the loss of these cells.
When the number of CD4+ T cells in the blood of a person living with HIV drops dangerously low and they get one or more serious infections, doctors may diagnose them with AIDS (less than 200 cells per cubic millimeter of blood).
HIV and mental health are very much related to each other. People living with HIV suffer from many mental health issues over their life.
In this article, we are going to talk about how mental health and HIV are related, the most reported mental health issues seen in HIV patients.
We will also look into how to improve mental health in HIV patients. We all have some prejudices regarding HIV which we are going to address here too.
Most Common Mental Health Issues Faced by People Living With HIV
According to the WHO, AIDS has “substantial” effects on mental health. Up to 20% of PLWHA may develop psychiatric problems as their first medical signs of AIDS, and 38 to 73% of HIV/AIDS patients may experience at least one psychological condition in their lifetimes in addition to the usual emotional responses of “anger, guilt, denial, and despair.”
Depression
Among the mental health disorders that HIV patients may face, depression is among the most common. One 2019 review estimated that 31% of people who are HIV-positive suffer from depression.
A 2019 analysis underscores the potential significance of innate immunity in depression, in addition to stigma and stress. Biological alterations linked to depression, anxiety, and suicidal ideation have been linked to the persistent stress and inflammation that HIV causes in the immune system.
Anxiety
HIV has also been linked to an increase in the prevalence of anxiety disorders. According to a 2019 report, approximately 20% of HIV-positive people in the United States suffer from Generalized anxiety disorder (GAD).
People living with HIV have a higher-than-average prevalence of anxiety disorders, including severe anxiety and social anxiety disorder, according to a review published in 2024 by a reliable source.
Suicidal Ideation
High rates of suicide ideation are all associated with HIV infection. According to a comprehensive evaluation conducted in Africa in 2021, around 21.7% of people with HIV had suicidal thoughts at some point. This increased rate is likely due to factors like deterioration in health, co-occurring disorders, stigma, and inadequate care. Lowering depression can prove to be a great suicide prevention measure.
Central Nervous System Disease
HIV is a major contributor to systemic inflammation. Inflammation of the central nervous system can create difficulties in the brain and spinal cord.
Daily dosing with an HIV drug cocktail known as antiretroviral therapy (ART) helps halt the virus’s replication and spread across the body. However, even with effective ART, HIV-positive persons still face a risk of developing neurocognitive disorders. These conditions may be neurological or neurocognitive (affecting the nervous system).
When compared to HIV-positive individuals who are not on ART, those who utilize ART are less likely to experience severe neurological deficits such as dementia, brain shrinkage, and encephalitis (brain inflammation). HIV is linked to both severe and milder kinds of central nervous system illness.
What Are the Reasons for Psychological and Biochemical Issues?
We have mentioned the typical HIV and mental health problems above. But what is the underlying cause? According to researchers, perceived stigma, and low levels of resilience influence the prevalence of these psychological issues.
HIV-positive individuals who are less resilient and score higher on the perceived stigma scale are more likely to develop the mentioned mental disorders.
Taking steps to strengthen the resilience of the individuals living with HIV and reducing the stigma surrounding it can lower the number of mental health issues.
The development of effective antiretroviral therapy (ART). However, ART has been linked to metabolic alterations, which has doctors worried. Doctors have noticed that blood glucose and lipid are abnormal in patients who are taking ART.
Antiviral agents, especially protease inhibitors, appear to have a stronger connection to these alterations. How often these metabolic abnormalities arise is the subject of many ongoing investigations. However, they will make patients more susceptible to heart disease or diabetes issues in the future.
Can HIV Medication Bolster Your Mental Issues?
Anti-HIV medications might have an impact on your mental and emotional well-being. Some people struggle with issues such as sadness, anxiety, restlessness, vivid nightmares, and vertigo. Most noticeably, this has a slight impact on those taking the following medications:
- Dolutegravir
- Efavirenz
- Rilpivirine
The majority of issues are most prevalent in efavirenz users. Because of this, the British HIV Association no longer suggests using efavirenz as the first HIV medication.
People who have a history of psychological problems may have an increased risk of experiencing adverse effects if they begin taking one of these medications. Before beginning HIV treatment, it’s crucial to let the personnel at your HIV clinic know if you’ve ever experienced depression or any other issues. Efavirenz may not be the best option for you, especially if you have a history of depression.
Why Does an HIV Patient’s Mental Health Worsen Because Of Stigma?
HIV stigma refers to unfavorable perceptions of those who have the virus. The discrimination that results from classifying someone as a member of a group is what is deemed to be improper in society. Here are a few examples;
- Believing that HIV can only infect particular types of people
- Passing moral judgment on those who take action to stop the spread of HIV
People with HIV suffer emotional and mental health consequences as a result of HIV stigma and prejudice. People with HIV frequently internalize the stigma they encounter and start forming a poor opinion of themselves. They might worry that others will treat them differently or judge them harshly if they divulge their HIV status.
When a person begins to apply the negative beliefs and stereotypes about persons living with HIV to themselves, this is known as “internalized stigma” or “self-stigma.” Internalized HIV stigma can cause emotions of guilt, loneliness, and hopelessness. They might start keeping themselves isolated. Many even hesitate to get tested or receive HIV treatment due to these emotions.
How Does HIV Affect Depression?
Many medical practitioners think that depression will inevitably follow HIV patients. Although receiving the diagnosis will undoubtedly cause anxiety and anguish, sometimes to a degree that it interferes with functioning and may even result in suicidal ideation, this type of situation-specific emotional reaction is not the same as depression.
Supportive and other forms of psychotherapy, as opposed to medication, will be more effective in helping someone cope with the emotional discomfort caused by receiving an HIV diagnosis.
HIV can harm subcortical brain regions, resulting in HIV dementia and states that are misdiagnosed for clinical depression. Other physical and endocrine issues that might lead to mood changes can occur in HIV patients. Hepatitis, pneumocystis carinii pneumonia, and endocrinopathies are only a few examples of systemic diseases related to HIV infection that can mimic sadness. Malnutrition, particularly when it results in B6 and B12 deficiency, can also simulate depression.
| HIV Medication | May Trigger |
| Interleukin | Depression, disorientation, and confusion |
| Steroids | Mania or depression |
| Interferon | Neurasthenia fatigue syndrome, depression |
| Stavudine | Depression or mania, asthenia |
| Zidovudine | Maina, depression |
| Efavirenz | Decreased concentration, depression, nervousness, nightmares |
| Vinblastine | Depression, cognitive impairment |
Depression symptoms include:
- Regularly feeling depressed or empty
- Having a negative or dismal attitude
- A sense of worthlessness or guilt
- Feeling agitated or uneasy
- Loss of interest in things you normally love doing
- Decreased energy or weariness
- Shifts in sleeping patterns
- Modifications to appetite or weight
- Slowed down actions or utterances
- Problems with memory or attention
- Undiagnosed aches, pains, or gastrointestinal problems
- Suicidal ideation or past suicide attempt
Depression symptoms can differ from person to person.
Can Antiretroviral Drugs Cause Psychosis?
In some circumstances, yes. Patients with severe delusions, cognitive problems, hallucinations, and distortions of reality are referred to as having psychosis. Psychosis may be a symptom of psychiatric diseases including schizophrenia, affective disorders, or delirium.
According to studies, abruptly stopping antiretroviral therapy can significantly reduce psychiatric morbidity in HIV-infected people who experience sudden onset psychotic disorders in the absence of other recognized organic or other causative variables.
However, antipsychotic drug therapy can reduce psychotic symptoms and make it possible to resume antiretroviral therapy.
How To Improve Mental Health?
When you receive an HIV diagnosis, it is very normal to experience unpleasant emotions. These responses do not persist indefinitely. You may take better care of your psychological health in various ways, as mentioned in this article. Here are a few examples:
- Start HIV drugs (ART) as soon as possible. An efficient ART regimen will boost and safeguard your health as well as the health of your sexual partners, and the awareness that you are doing this significant step may enhance your feelings toward yourself and the future.
- Discuss your feelings with your service providers, friends, family, or other encouraging people.
- Try to find stress-relieving activities, like exercise or a hobby.
- To feel rested, make an effort to obtain adequate sleep each night.
- Learn how to relax by practicing yoga, meditation, or deep breathing.
- Reduce your coffee and nicotine intake.
- Throughout the day, eat small, wholesome meals.
- Sign up for a support group.
The Happiness Analysis Among People, living with HIV
The assessment of 148 respondents’ responses to the study on PLWHA (people living with HIV AIDS) happiness in Denpasar yielded numerous conclusions, such that 62.17 percent of PLWHA in Denpasar reported feeling pleased, 30.40 percent reported being extremely happy, and 7.43 percent reported being less happy. Men’s percentages of happiness were 8.44 percent sad, 62.65 percent happy, and 28.91 percent extremely happy among the 83 PLWHA, while women’s percentages of happiness were 6.16 percent unhappy, 60 percent happy, and 33.84 percent happy among the 65 PLWHA.
The spirituality of PLWHA in Denpasar City is positively and significantly impacted by socioeconomic and environmental factors. Psychological factors, however, have little impact on the level of religion among PLWHA in Denpasar City. The contentment of PLWHA is unaffected by socioeconomic factors, psychological issues, or environmental variables in
The city of Denpasar. Religion significantly and favorably impacts the happiness of PLWHA in Denpasar City. Both socioeconomic and environmental factors, as well as happiness among PLWHA in Denpasar City, were fully mediated by religiosity, but the happiness of PLWHA in Denpasar City was not mediated by religiosity when it came to psychological aspects.
HIV Myth Busters
Due to my HIV status, I cannot become a parent
It might be safe for you to have kids. Your health care provider can advise you on how to eliminate or greatly reduce the likelihood of transmitting the virus to your unborn child throughout the gestational period. To safeguard you and your unborn child while your pregnancy, your doctor will prescribe HIV medications. After birth, the baby can also get medicine.
If you have HIV, can you breastfeed?
In the US, breastfeeding is not advised for HIV-positive women. Researchers discovered that taking antiretroviral medication while nursing almost completely decreased the chance of HIV transmission. Less than 1% of infants who were nursed for a year, exactly 0.6%, acquired HIV via breast milk. The transmission rate, however, is not zero. Therefore, we do not suggest doing so.
If I have HIV, is it safe for me to marry someone who doesn’t have it?
Yes, but you have to be careful. It’s safe to hug your partner and kiss. There is no danger of HIV transmission if you are receiving HIV therapy and have an eradicated viral load. Another efficient method of preventing HIV infection during intercourse is by using condoms.
Can I, an HIV-positive participate in sports?
Yes! When it comes to sports, having HIV is no different from having HIV not. Everyone, even those with HIV health conditions, benefits from regular exercise and physical activity.
Does having HIV impact your career?
No. Many HIV-positive persons can have regular, healthy lives with the right care and treatment, which includes working. The majority of HIV-positive people can keep their current employment or hunt for new ones in their preferred fields. Being gainfully employed might help you live a more physically and financially stable life.
Bottom Line
Now it is possible to fight HIV with effective drugs. The journey of an HIV patient is tough and to get through it they have to strengthen their mental health. All they need is to know how to improve mental health. Joining discussion groups for HIV can help. HIV care institutions often provide these facilities along with treatment support.