J Korean Soc Biol Ther Psychiatry.  2020 Oct;26(3):184-194.

Psychiatric Understanding and Treatment Consideration in HIV Infection

• Jang S
• Rim HD
• Kim K
• Kim BS
• Woo J

Abstract

Following the development of human immunodeficiency virus (HIV) treatments, the mean lifespan of patients with an HIV infection has increased to a level comparable to the general population. Patients receiving HIV treatment can achieve viral suppression and perform routine activities without the risk of infection transmission. Recently, the quality of life (QoL) and mental health of patients are becoming the primary outcomes in HIV treatment. The objective of this review was to investigate psychiatric disorders in patients with an HIV infection and available treatment programs. A search for clinical studies and scientific publications was performed. Patients with an HIV infection had a higher prevalence of psychiatric disorders than the general population. The psychopathological factors in HIV infection included neurobiological changes of infection, side-effects of medications, negative social perception, and unresolved intrapsychic conflicts. Severe and unmanaged psychiatric disorders with HIV infection negatively impacted HIV infection transmission and treatment adherence. However, psychiatric treatment programs and referrals to a psychiatric professional were found to be insufficient in most countries. This review revealed a need for psychiatric interventions in clinical practice to improve patients’ mental health and HIV treatment adherence. Psychiatric interventions integrated with conventional HIV treatment can be efficacious to achieve this goal. In addition, clinicians need to investigate and recognize HIV-related stigma as the relationship between patients and clinicians has a significant role in the patient’s treatment adherence.

Keyword

HIV Infections; Psychiatry; Social Stigma; Treatment adherence; Integrated health care systems