Gender, HIV Status, and Psychiatric Disorders

Abstract

Objective More than thirty years after the onset of the HIV epidemic, there is no information on the prevalence of psychiatric disorders among HIV-positive individuals in the general population. We sought to compare the prevalence of 12-month psychiatric disorders among HIV-positive and HIV-negative adults stratified by sex, and to examine the differential increase in risk of a psychiatric disorder as a function of the interaction of sex and HIV status. Methods Face-to-face interviews conducted between 2004 and 2005 with participants in a large nationally representative sample of US adults (34,653). Results When compared with their HIV-negative same sex counterparts, HIV-positive men were more likely to have any mood disorder (Odds ratio [OR]=6.10; 95%; Confidence interval [CI] =2.99–12.44), major depressive disorder/dysthymia (OR=3.77; 95% CI=1.16–12.27), any anxiety disorder (OR=4.02; 95% CI=2.12–7.64), and any personality disorder (OR=2.50; 95% CI=1.34–4.67) In relation to their same sex HIV-negative counterparts, the effect of HIV status on the odds of any mood disorder (OR=7.17; 95% CI=2.52–20.41), any anxiety disorder (OR=3.45; 95% CI=1.27–9.38) and any personality disorder (OR=2.66; 95% CI=1.16–6.10) was significantly greater for men than women. Conclusions HIV status was significantly more strongly associated with psychiatric disorders in men than women. HIV-positive men had a higher prevalence than HIV-negative men of most psychiatric disorders. By contrast, HIV-positive women were not significantly more likely than HIV-negative women to have psychiatric disorders.

A systematic review of personality disorders and health outcomes.

“…The presence of hypertension/atherosclerosis, hepatic disease, cardiovascular disease, gastrointestinal disease, arthritis, venereal disease, or other medical condition was associated with a greater likelihood of having BPD, even after adjusting for demographic characteristics and psychopathology. The NESARC data also revealed that PDs were associated with self-reported HIV status (Lopes et al, 2012). Compared to their HIV-negative sex-matched counterparts, HIV-positive men were more likely to have a PD (43.17% vs. 23.28%; OR = 2.50).…”

Validity of the patient health questionnaire-9 to screen for depression in a high-HIV burden primary healthcare clinic in Johannesburg, South Africa

“…The relationship between MDD and HIV is complex, as depression can be a risk factor for HIV acquisition as well as a consequence of HIV infection (Smit et al, 2006, Simoni et al, 2011). However, MDD has long been recognized as a predictor of negative clinical outcomes among people with HIV (Bing et al, 2001, Simoni et al, 2011, Owe-Larsson et al, 2009, Lopes et al, 2012). Persons with depression initiate anti-retroviral treatment (ART) at lower CD4 counts than people without mental illness, and depressed patients are much less likely to adhere to ART than patients who are not depressed (Tegger et al, 2008, Gonzalez et al, 2011, Nakimuli-Mpungu et al, 2012a, Kaharuza et al, 2006).…”

HIV-1 proteins accelerate HPA axis habituation in female rats

“…The development of these disorders has been proposed to be due to the psychosocial burden that is associated with the diagnosis of HIV positive status (Lichtenstein, Laska et al 2002), stress stemming from occupational-related problems, lack of social support, cultural biases associated with infection, and/or resource-poor environments (Brown 2001; Wohl, Galvan et al 2010; Kamau, Kuria et al 2012). It is estimated that 30 - 50% of people living with HIV have a stress-related mood disorder such as depression, compared to only 6.5% of the general population (Hinkin, Castellon et al 2002; Lopes, Olfson et al 2012). Psychological problems can arise at a very young age in patients chronically infected with HIV (Gadow, Angelidou et al 2012), with anxiety and depression being more common in females (Mellins, Elkington et al 2012).…”