HIV is a virus that attacks and alters the immune system. Without treatment it can progress to an advanced stage called AIDS. Receiving a diagnosis of HIV and living with the condition can have a negative impact on a person’s mental health.

The stress of living with a serious condition such as HIV can affect a person’s mental health and increase the risk of developing mood, anxiety, and cognitive conditions. The stigma and discrimination associated with HIV can also result in negative mental health outcomes.

Fortunately, many mental health problems are treatable, and help is available for people living with HIV. Talking therapies, medications, and social support can all be beneficial.

In this article, we will discuss the prevalence of mental health conditions among individuals living with HIV, as well as treatment options, and where to find support.

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Research indicates that at the end of 2020, roughly 37.6 million people were living with HIV.

According to the National Institute of Mental Health (NIMH), people living with HIV are at a higher risk for developing mental health conditions. For example, evidence suggests that people living with HIV are twice as likely to have depression, compared with people who do not live with HIV.

There are many specific sources of stress relating to HIV that can contribute towards poorer mental health. People living with HIV may experience difficulties and barriers towards managing and accessing medical support.

Additionally, people living with HIV may experience stigma and discrimination associated with the condition, which can affect their emotional well-being and mental health. This can also result in health inequity and negatively impact a person’s social determinants of health.

Some forms of treatment for HIV, such as antiretroviral therapy (ART), may also cause side effects that can affect mental health. In some cases, experiencing poorer mental health may also affect the initiation of and adherence to these drugs.

It is also understandable that people may experience a wave of emotions, such as anger and denial, following a HIV diagnosis, which can have an impact on their mental health.

A 2019 review notes that in the United States, the prevalence of HIV is much higher among adults with serious mental health conditions, compared to the general population. This may be due to risk factors they are more likely to experience, such as higher risk sexual behaviors.

The same review adds that people living with HIV experience higher rates of mental health conditions. For example, the review states that in an older U.S. study, 36% of people living with HIV had major depression and 15.8% had generalized anxiety disorder, compared to 7.1% and 3.1%, respectively, in the general population.

Depression is one of the most common mental health conditions a person with HIV may experience. A 2019 review suggests that the prevalence of depression among people living with HIV is 31%, while other sources suggest it may be higher at roughly 39%.

In addition to the stigma and stress that can contribute towards depression, a 2019 review highlights the potential role of the immune system. Evidence suggests that the chronic stress and inflammation HIV places on the immune system can result in chemical changes associated with depression, anxiety, and suicide.

Anxiety disorders are another common mental health condition associated with HIV. A 2019 article notes that nearly 1 in 5 HIV-positive adults in the U.S. experience generalized anxiety disorder.

A 2016 review adds that the prevalence of many anxiety disorders, such as panic disorder and social anxiety disorder, are typically higher in people living with HIV, compared to the general population.

Suicide ideation, attempts, and risk are high among people living with HIV.

A 2021 systematic review in Africa notes that the prevalence of suicidal ideation was roughly 21.7% in people living with HIV. Deterioration of medical condition, comorbid conditions, stigma, and poor support likely contribute to this higher rate.

However, a 2019 Swiss study highlights that while the rate of suicide among people living with HIV remains roughly three times the general population, the rates have decreased substantially within the last 3 decades.

If people suspect that a person is at immediate risk of suicide, they should call 911 or a local emergency number. People should try to provide as much accurate information as the emergency services require.

Suicide prevention

If you know someone at immediate risk of self-harm, suicide, or hurting another person:

  • Ask the tough question: “Are you considering suicide?”
  • Listen to the person without judgment.
  • Call 911 or the local emergency number, or text TALK to 741741 to communicate with a trained crisis counselor.
  • Stay with the person until professional help arrives.
  • Try to remove any weapons, medications, or other potentially harmful objects if it’s safe to do so.

If you or someone you know is having thoughts of suicide, a prevention hotline can help. The 988 Suicide and Crisis Lifeline is available 24 hours a day at 988. During a crisis, people who are hard of hearing can use their preferred relay service or dial 711 then 988.

Find more links and local resources.

HIV can cause inflammation throughout the body, including the spinal cord and brain. This can result in central nervous system diseases that can affect the nervous system, cognition, or mental processing.

For example, HIV encephalopathy is a potential complication of HIV due to inflammation of the brain. It may cause a person to experience sudden shifts in mood or behavior, forgetfulness, and confusion.

It is important that a person begins HIV treatment as soon as possible after their diagnosis for the best health outcome.

HIV treatment typically involves a combination of ART, which can control and suppress the virus. Following a treatment plan can be difficult, however strategies are available that can help.

While ART can help manage symptoms of HIV, some drugs may cause symptoms of depression, anxiety, and sleep disturbances, which can all negatively affect mental health.

Therefore, it is important for people living with HIV to speak with a healthcare professional about their mental health. This is particularly true since some medications may interact with ART.

A person living with HIV may consider treatments such as talking therapy and medications to support their mental health. Working with a mental health professional can help a person evaluate their options and develop a plan to maintain good mental health.

The Centers for Disease Control and Prevention (CDC) offer a list of resources to help with a range of issues. This includes a list of mental health treatment programs available from the Substance Abuse and Mental Health Services Administration (SAMHSA).

Resources also include a search tool that can help people find HIV mental health services in their area and a webpage featuring toll-free phone numbers. The Health Resources and Services Administration also runs a program that provides medical care for people living with HIV with no or insufficient health insurance.

Both HIV and AIDS are highly stigmatized conditions that may cause a person to experience feelings of persecution, isolation, and exclusion. The stress of managing the condition and the medications themselves may also contribute to poorer mental health.

A diagnosis of HIV can be very distressing, and feelings of depression and anxiety are common. However, services are available to help people manage the stigma and discrimination and receive additional support.

It is important for people living with HIV to begin HIV treatment immediately and speak with a healthcare professional about their mental health. A mental health professional can discuss their options and suggest treatments such as talking therapy.