Silent No More

Abstract

“Silent No More” is the story of a resilient 58-year-old man who has a complex history of alcohol use disorder, depression, HIV, and social isolation. The important factors that contribute to depression, stigma, and social isolation are reviewed. Using these factors, a comprehensive approach to the patient’s problems and needs is presented. The evidence for treatment of depression and depression cofactors for people living with HIV is reviewed. Education about mental health, substance use disorders, and trauma must be presented. Syndemics also must be discussed. Comprehensive mental health care involves medication and nonmedication strategies. Because people living with HIV are living longer, their quality of life must be addressed in relation to the information presented.