The Role of Psychiatrists in HIV Prevention

published on March 20, 2016 by Mary Ann Cohen, MD, Kelly L. Cozza, MD, James A. Bourgeois, OD, MD, Yavar Moghimi, MD, and Antoine Douaihy, MD, in Psychiatric Times

Psychiatrists are uniquely positioned to provide both preventive and therapeutic interventions for children, adolescents, adults, and elderly persons who are vulnerable to, infected with, or affected by HIV. Psychiatrists routinely take patient histories that include substance use; sexual activities; relationships; and trauma, including childhood neglect and emotional, physical, and sexual abuse—as well as comprehensive medical, psychiatric, and social histories. Progress in preventing HIV infection has lagged far behind progress in the disease’s diagnosis and treatment. Stigma, discrimination, and fear may prevent persons with risk behaviors such as unprotected sex and injection drug use from getting tested, learning that they have HIV infection, or obtaining much needed care.

While there are similarities, HIV/AIDS differs from many complex and severe medical illnesses because it is an infectious and stigmatized disease that can lead to and is associated with other multimorbid medical illnesses. It is also associated with psychiatric illnesses because of the affinity of HIV for brain and neural tissue as well as its profound impact on persons who are infected.

Increasing awareness of stigma, discrimination, and psychiatric factors associated with the HIV pandemic can lead to decreased transmission as well as early diagnosis and treatment. Compassionate medical and psychiatric care can mitigate suffering in persons at risk for, infected with, and affected by HIV.

Prevention of HIV infection

Strategies have been developed for communicating, preventing HIV transmission, improving adherence to risk reduction and medical care, addressing health care disparities, and ameliorating stigma. These include the National AIDS Strategy Updated to 2020, the 2015 Blueprint to Eliminate AIDS in New York State, and the World Health Association Guidelines.

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The Role of Psychiatrists in HIV Prevention

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