HIV/AIDS-related psychological disorders

HIV and opportunistic diseases of the brain and nervous system can alter people's brain and nervous system, causing psychological disorders (Horwath, 2003). Psychological disorders associated with HIV include HIV-associated dementia (HAD), which includes symptoms such as forgetfulness, apathy, difficulty concentrating, speech problems, tremors, and delusions; minor cognitive-motor disorder (MCMD), which includes mild impairments in memory, movement, and concentration; mood disorders, such as depression; anxiety disorders; and brain tumors.

Additionally, people living with HIV/AIDS may suffer psychological distress as a result of the many physical, social, and economic effects of the disease on their lives. Among the various stressors are chronic physical pain, physical disfigurement, the possibility of infecting other people, and discrimination, abuse, and loss of fundamental human rights. Other challenges include changes in lifestyle to accommodate the illness itself and the financial burdens that treatment brings for oneself and one's family. People with HIV often also face loss of independence; physical, social, and emotional isolation; uncertainty concerning the timing and nature of treatment and disease progression; and uncertainty in their personal and social lives. Additionally, many people with HIV are simultaneously coping with grief from already having lost loved ones to AIDS (Cline, 1990; De Gagne, 1994). As a result of these many stressors, people diagnosed with HIV infection often suffer from a number of psychological symptoms, including anger, frustration, anxiety, depression, and chronic somatic preoccupation (ie, a fixation on physical symptoms) (Kelly et al, 1993b).

Meeting the needs of people with HIV helps everyone

There is a clear need for services that will improve the psychological health of people with HIV/AIDS (Demmer, 2001). Improved psychological services for people with HIV not only help them but also may help the general public (Kelly et al, 1993a). High levels of depression and maladaptive coping with HIV infection have been associated with substance use and risky sexual activities, which put others at risk for acquiring HIV (Kelly et al, 1993b).

The stress of HIV/AIDS can be buffered by the social support provided by support groups (Green & Smith, 2004; Kalichman, Sikkema, & Somlai, 1996). For example, in a study of men with HIV who were experiencing moderate depression, 86% of participants who attended a social-support group showed improved mental health, whereas about 67% of the participants who did not attend the social-support group showed worsened mental health (Kelly et al, 1993a). Support groups that target specific sources of emotional distress improve the number and quality of friendships, as well as provide health information that is especially beneficial (Kalichman et al, 1996).

Coping and stress management programs that are based on cognitive and behavioral theories and delivered to small groups can positively affect the mental health of people living with HIV/AIDS (Kelly & Kalichman, 2002). These interventions first teach people how to tell the difference between stressors that they can control or change and stressors that they cannot control or change. In response to the controllable stressors, these interventions then teach people how to address their problems in constructive and efficient ways. In response to the uncontrollable stressors, these programs teach people how to view their situations more positively and to deal with their negative emotions (Chesney, Chambers, Taylor, Johnson, & Folkman, 2003). Some of these interventions also teach people how to relax and avoid anxiety (Eller, 1999).