HIV and Elevated Mental Health Problems: Diagnostic, Treatment, and Risk Patterns for Symptoms of Depression, Anxiety, and Stress in a National Community-Based Cohort of Gay Men Living with HIV

Abstract

People living with HIV (PLHIV) have almost double the risk of depression than the rest of the population, and depression and anxiety among PLHIV have been linked with greater disease progression and other physical health problems. Studies to date, however, have focused almost exclusively on depression or general mental health. Much less research has investigated predictors of anxiety and generalized stress among HIV-positive gay men. This paper reports findings from a national community-based sample of 357 HIV-positive Australians gay men aged 18 years and older. Participants reported elevated rates of depression, anxiety, and generalized stress symptoms. A significant proportion of men with elevated depression and anxiety symptoms were not receiving treatment or had not been diagnosed. Risk factors for elevated mental health concerns included experiences of internalized stigma and discrimination. Anxiety was also associated with lower T-cell CD4 counts. A key protective factor was access to social support. The type of support, in particular emotional support, was found to be more important than the source of support. Our findings suggest that greater emphasis is needed on mental health screening and the provision of emotional support for PLHIV.

The Double Burdens of Mental Health Among AIDS Patients With Fully Successful Immune Restoration: A Cross-Sectional Study of Anxiety and Depression in China

“…Among our study's strengths is its large size and geographic diversity across 14 provinces in China and inclusion of many sub-populations. Also important was its use of validated measures to assess risk for anxiety and depression and that could easily be integrated into routine clinical practice (9, 22, 40). …”

HIV Futures 8: Protocol for a Repeated Cross-sectional and Longitudinal Survey of People Living with HIV in Australia

“…For example, TasP has the capacity to reduce the stigma associated with fear of transmission while simultaneously increasing stigma for those not taking treatment or with detectable viral loads (38). Stigma can affect mental health and well-being at the individual level (35, 39). It can also interrupt and undermine campaigns to increase testing for HIV and other prevention initiatives (40).…”

Examining anxiety sensitivity as an explanatory construct underlying HIV-related stigma: Relations to anxious arousal, social anxiety, and HIV symptoms among persons living with HIV

“…The MINI has been utilized in prior studies of HIV+ samples (e.g. Breuer et al, 2014) and has sound psychometric properties (see Lecrubier et al, 1997). In the current study, 12.5% of MINI diagnostic interviews were checked for reliability by a trained doctoral-level rater; no discrepancies were noted.…”

“…Such relations are evident across cultural groups (Kamen et al, 2015; Li et al, 2016) and gender (Brown, Serovich, Kimberly, & Hu, 2016). Thus, understanding the relationship between HIV related stigma and anxiety and HIV symptoms among PLHIV is of public health importance (Heywood & Lyons, 2016). Although past research has provided consistent evidence that HIV-related stigma is related to poor mental and physical health outcomes among PLHIV (e.g., Herek, Saha, & Burack, 2013), there remains a need to identify mediators of this relation in order to help to understand the mechanisms involved in this relation.…”