UK - PLHIV have an increased risk of mental illness

[Jim Allen]

Interesting read.

Aidsmap - June 6th 22
https://www.aidsmap.com/news/jun-2022/people-living-hiv-uk-have-increased-risk-mental-illness

In Short:

A study by Tiffany Gooden and colleagues in the Lancet HIV shows how people living with HIV in the UK are at higher risk of developing mental illness than people without HIV

It has been well documented that the prevalence of mental illness (including depression, anxiety, and severe mental illness) is higher amongst people living with HIV. However, this is probably the first study to report new cases of these conditions in people living with HIV, using a matched cohort population-based approach, therefore providing better evidence of the disproportionate impact of mental illness in people living with compared to people without HIV.

The study was conducted between 2000 and 2020 using data from a large UK primary care database to compare new mental illness in 7167 people living with HIV and a control group of people without HIV, who had no diagnosis of mental illness.

Their findings show that 586 people living with HIV developed mental illness, compared to 418 people without HIV in 20 years of the study (incidence rate of 19.6 and 12.1 per 1000 people-years, respectively). This means that for every 1000 people with HIV followed for a year, 19 people would be expected to develop mental illness.

More specifically, they found a higher incidence of depression, anxiety, and severe mental illness (such as psychosis, schizophrenia, and bipolar disorder) in people living with HIV than in people without HIV. 495 people living with HIV developed depression, 266 anxiety and 64 severe mental illness, compared to 298, 214 and 30 respectively in people without HIV.

However, this study has some limitations. It was conducted at a time (2003-2015) when efavirenz was commonly prescribed, and its side effects (including mood disturbances) might have been recorded as mental health conditions.

Additionally, their data set didn’t include the mode of transmission and sexual orientation, and the prevalence of HIV found (0.11%) is lower than national estimates (0.15%) potentially due to people not sharing their status with their general practitioner.

These limitations mean further studies are needed to investigate the increased risk of mental illness in people living with HIV. They also heighten the importance of understanding the biological mechanisms and psychosocial factors (including stigma) that act as drivers and barriers to screening and diagnosing mental illness.

The higher rates of mental illness diagnoses amongst people living with HIV in the study can be due to higher contact with healthcare professionals, persistent immune activation caused by HIV infection, stigma and discrimination, and existing socio-economic inequalities.