HIV and mental health

Marlon Gattiker, Swiss AIDS Federation

In many countries, there is less than one psychiatrist per 100,000 people. For people living with HIV in particular, who have a higher than average prevalence of mental distress, this represents a significant shortfall in healthcare provision. Jerome Galea, psychologist and Associate Professor of Social Work at Harvard University, explains the impact of mental distress on living with HIV and proposes solutions for better holistic healthcare.

What is the potential impact of depression on HIV?

• Access to HIV treatment becomes more difficult.
• ART adherence decreases. 
• Drug and alcohol use increases. 
• Viral load can increase despite high ART adherence.

What do these findings mean for working with people living with HIV in Switzerland? How can their mental health be improved and mental stress prevented?

It is essential to create an environment at all levels (medical, social, political) that supports the mental health of individuals and communities. For example, more awareness of mental health is needed. Depressed people often express their complaints as stomach aches or headaches because they lack the necessary vocabulary for mental stress. More education ensures greater awareness. On the other hand, more capacity is needed in healthcare for psychosocial issues. Context-appropriate approaches to mental health are needed, in partnership with relevant communities.