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Consultation, Assessment, and Evaluation

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HIV Psychiatry

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Abstract

Persons with HIV can live longer healthier lives if they are engaged in HIV care and adherent to antiretroviral medication. With adherence, persons with HIV/AIDS may have the same longevity as the general population. However, psychiatric disorders may interfere with both care engagement and medication adherence. This chapter presents the most prevalent psychiatric disorders that may disrupt the clinician-patient relationship, prevent adequate care engagement, increase HIV transmission, and decrease adherence to antiretroviral medication.

With the goal of HIV/AIDS treatment being viral suppression, consistent engagement of persons with HIV/AIDS in their medical management is essential. Missed appointments, nonadherence to ART, biopsychosocial factors, and comorbid mental illness all can prevent patient involvement in treatment, leading to a lack of viral suppression. Nonadherence to medical care complicates the course of illness, intensifies patient suffering, strains relationships, and increases morbidity and mortality. Missed appointments are associated with all-cause mortality in persons with HIV. In this chapter, we present the basic assessment needed to evaluate persons with HIV for comorbid psychiatric disorders to decrease HIV transmission and increase adherence to HIV care.

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Author information

Authors and Affiliations

  1. Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA

    Mary Ann Adler Cohen

  2. Family Medicine Residency, Eglin Air Force Base Hospital, Eglin AFB, FL, USA

    Danielle Wilkin

  3. Department of Psychiatry, NYU School of Medicine, New York, NY, USA

    Mark V. Bradley

  4. Consultation-Liaison Psychiatry Service, Columbia University Irving Medical Center, New York, NY, USA

    Luis F. Pereira

  5. Department of Psychiatry, Uniformed Services University of the Health Sciences, Bethesda, MD, USA

    Kelly L. Cozza

  6. Department of Psychiatry, New York Presbyterian Hospital-Columbia Campus/New York State Psychiatric Institute Program, New York, NY, USA

    Christina M. Patel

Authors
  1. Mary Ann Adler Cohen
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  2. Danielle Wilkin
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  3. Mark V. Bradley
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  4. Luis F. Pereira
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  5. Kelly L. Cozza
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  6. Christina M. Patel
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Corresponding author

Correspondence to Mark V. Bradley .

Editor information

Editors and Affiliations

  1. Baylor Scott & White Health, Texas A&M University, Temple, TX, USA

    James A. Bourgeois

  2. Icahn School of Medicine at Mount Sinai, New York, NY, USA

    Mary Ann Adler Cohen

  3. School of Medicine, Georgetown University, District of Columbia, Washington, DC, USA

    Getrude Makurumidze

Multiple Choice Questions

Multiple Choice Questions

  1. 1.

    Persons with HIV/AIDS experience mental illness at a rate far higher than the general population. Of the psychiatric disorders listed below, which is the most common among persons with HIV/AIDS?

    1. (a)

      Depressive disorder

    2. (b)

      Personality disorder

    3. (c)

      Trauma-related disorder

    4. (d)

      Psychotic disorder

    Correct answer: (a).

    Reference: Parhami I, Fong TW, Siani A, Carlotti C, Khanlou H. Documentation of psychiatric disorders and related factors in a large sample population of HIV-positive patients in California. AIDS Behav. 2013;17(8):2792–801.

  2. 2.

    Persons with HIV/AIDS and mental illness are at increased risk for which of the following, regardless of the specific psychiatric diagnosis?

    1. (a)

      Increased HIV risk behavior

    2. (b)

      Impaired metabolism of antiretroviral medications

    3. (c)

      Decreased adherence to treatment regimen

    4. (d)

      Delayed HIV testing

    Correct Answer: (c)

    References: Mehta S, Moore RD, Graham N. Potential factors affecting adherence with HIV therapy. AIDS. 1997;11(14):1665–670.Wagner G, Kanouse D, Koegel P, Sullivan G. Adherence to HIV antiretrovirals among persons with serious mental illness. AIDS Patient Care and STDs. 2003;17:179–86.

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Cohen, M.A.A., Wilkin, D., Bradley, M.V., Pereira, L.F., Cozza, K.L., Patel, C.M. (2022). Consultation, Assessment, and Evaluation. In: Bourgeois, J.A., Cohen, M.A.A., Makurumidze, G. (eds) HIV Psychiatry. Springer, Cham. https://doi.org/10.1007/978-3-030-80665-1_4

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