Fighting HIV: No Health without Mental Health

Fighting HIV: No Health without Mental Health

December 1, 2016

By: Joshua A. Gordon, M.D., Ph.D., Director, National Institute of Mental Health and Jimmy Kolker, HHS Assistant Secretary for Global Affairs

In 2014, the Joint United Nations Programme on HIV/AIDS (UNAIDS) launched a Fast Track strategy to eliminate HIV by 2030. Fast Track encompasses efforts to increase testing, and more rapid initiation of treatment, and simplifies and maintains long-term adherence to effective therapy. The goal is to suppress HIV in people living with the virus so that it becomes virtually undetectable, extending the lifespan of people living with HIV and preventing further transmission.
Over the past 30 years, the HIV epidemic has shown doctors, patients, advocates, and researchers that one of the major obstacles in reaching that goal has to do with mental health.  There is a powerful two-way relationship between HIV infection and mental disorders. Mental and substance use disorders can increase vulnerability to acquiring HIV infection and they can pose serious barriers to successful management of HIV.  Conversely, HIV infection itself affects the brain; in some cases, infection can result in symptoms of dementia and psychosis. Moreover, living with a chronic disease, like HIV, is often accompanied by anxiety and depression. These common mental disorders occur more frequently in people with HIV than in the general population; they can occur following a positive test result or as the HIV disease progresses.
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