HIV in Canada: A primer for service providers

 

Mental Health

Key Points

  • Mental health conditions are risk factors for HIV transmission.
  • Mental health conditions may affect health outcomes of people with HIV.
  • Depression may lead to negative health outcomes in people living with HIV.
  • People with HIV can experience any number of anxiety disorders, some at rates higher than the general populations

Mental health conditions have been shown to increase the risk of getting HIV. Overall an estimated 0.17% of Canadians have HIV, however, studies show a much higher HIV rate among those with a mental illness – studies show that between 5% and 23% of people with chronic mental health issues have HIV. The risk of HIV transmission is higher in people with mental health conditions primarily because they are more likely to engage in high-risk activities related to sex and drug use.

People with HIV are also impacted by mental health issues, especially depression and anxiety. Mental health issues among people with HIV can negatively impact their health outcomes. For example, mental health issues can affect their ability to find and be retained in care, and decrease their ability to remain adherent to HIV treatment once they start it. Therefore, people with HIV should be screened for any mental health issues.

Depression is a serious medical illness that negatively affects how someone feels, the way they act and how they think. It can interfere with daily life and reduce quality of life. Some research suggests that almost one-quarter of people with HIV experience depression at some point in their life. Treatment of depression can be complex for people with HIV. Effective treatment for depression can include individual and group counselling, cognitive behavioural therapy and antidepressant drugs.

Anxiety is a normal physical and emotional reaction to a perceived threat. However, anxiety becomes a clinical disorder when it starts to interfere with normal functioning. There are many different types of anxiety disorders – panic disorder and agoraphobia, social phobia and other phobias, obsessive compulsive disorder (OCD), post-traumatic stress disorder (PTSD), generalized anxiety disorder (GAD), acute stress disorder and anxiety disorder due to a general health condition. People with HIV can experience any of these anxiety disorders – some at rates comparable to the general population, while others are exacerbated by HIV. Anxiety disorders can be treated through pharmacological and non-pharmacological treatments

Resources

HIV and emotional wellness

CAMH – Centre for Addiction and Mental Health

Canadian Mental Health Association

Talking about Depression, Anxiety and HIV/AIDS – Canadian AIDS Society

Sources

  1. World Health Organization. HIV/AIDS and mental health, WHO, Geneva, 20 November 2008. Available from: http://apps.who.int/gb/archive/pdf_files/EB124/B124_6-en.pdf
  2. Public Health Agency of Canada. Summary: Estimates of HIV Incidence, Prevalence and Canada’s Progress on Meeting the 90-90-90 HIV targets, 2016. Public Health Agency of Canada, 2018. Available from: https://www.canada.ca/en/public-health/services/publications/diseases-conditions/summary-estimates-hiv-incidence-prevalence-canadas-progress-90-90-90.html
  3. American Psychiatric Association. HIV Mental Health Treatment Issues: HIV and Clinical Depression. Available from: https://www.psychiatry.org/File%20Library/Psychiatrists/Practice/Professional-Topics/HIV-Psychiatry/FactSheet-Depression-2012.pdf
  4. American Psychiatric Association. What is Depression? Available from: https://www.psychiatry.org/patients-families/depression/what-is-depression
  5. Anxiety Disorders Association of Canada. Generalized Anxiety Disorder. Available from: https://www.anxietycanada.com/adults/generalized-anxiety-disorder
  6. Canadian Mental Health Association. Anxiety disorders. Available from: http://www.cmha.ca/mental-health/understanding-mental-illness/anxiety-disorders/
  7. American Psychiatry Association. HIV Mental Health Treatment Issues: HIV and anxiety. Available from: https://www.psychiatry.org/File%20Library/Psychiatrists/Practice/Professional-Topics/HIV-Psychiatry/FactSheet-Anxiety-2012.pdf