World Aids Day is observed every year on December 1 in order to raise awareness across the globe about AIDS and HIV. This day is dedicated towards uniting in the collective fight against HIV and the discrimination faced by people living with AIDS. This year the theme of World AIDS day is “Global Solidarity, shared responsibility”, as we all together need to play our part to make this world a healthier and more equal place, where there is an equal access to quality healthcare and other resources and where no one is discriminated against based on their identity or medical condition.
The coronavirus pandemic has already negatively impacted underprivileged communities, but in addition to that the challenges faced by people living with HIV have also been aggravated. Marginalised and at-risk populations like women and people belonging to the LGBTQIA community have become more vulnerable. Out of the thirty- eight million people living with HIV in the world in 2019, 12.6 million do not have access to treatment. No individual or community should be deprived of life saving medicines and healthcare. Not having access to public healthcare and treatment can have an adverse impact on one’s mental health. As a society, we have stigmatised and discriminated against people with HIV, thus a lot of these individuals experience lack of social support, exclusion, stigmatisation, and isolation. Being denied employment opportunities, community support, etc. are potential stressors that can be extremely hard for people who’re HIV positive to cope up with.
Intersecting social stigmas, and criminalization in some contexts (e.g. sex work, drug use, and same-gender sex) present additional challenges to key populations that are highly affected by HIV, including transgender women, sex-workers, people who use drugs, and racial and ethnic minorities. These groups experience perceived and internalized stigma as well as enacted stigma (e.g. discrimination) that negatively affect mental health, and this relationship is further compounded by the unfortunate stigma of mental illness in society and among patients and providers (Remien, et. al, 2019).
Researches have suggested that depression is the most prevalent mental health difficulty experienced by HIV positive people, followed by anxiety. A number of sociological variables play a role in impacting emotional well- being, this is highlighted from the fact that HIV- infected women are more at risk of poor mental health as compared to HIV- infected men. Apart from these factors, the chronicity of the illness, the manifestation and nature of physical symptoms, and medication can also have an impact on psychological health. For example, coming to terms with and facing reality about the chronic nature of the illness can be distressing and anxiety provoking. The medication taken as a part of the treatment for HIV can also have side effects and is known to trigger symptoms of depression, anxiety, and other mental health disturbances.
The WHO recommends that attention to the psychosocial needs of people with AIDS should be an integral part of HIV care. This includes assistance with employment, income, housing, informed decision-making, coping with illness and discrimination, and prevention and treatment of mild and serious mental health problems (Collins, et. al, 2006).
There is therefore an immediate need for integrating mental health services with the treatment of HIV. As we cannot address the AIDS epidemic without mentioning and talking about the mental health concerns surrounding it. We as a society need to work towards creating awareness about AIDS and normalising it through debunking the myths and stereotypes that surround AIDS/HIV. Mental healthcare which includes therapy or counseling should be provided as a part of the treatment right from when the diagnosis happens, and this is only possible if more resources are allocated towards the treatment of HIV. It is crucial to remember that this is a collective struggle and we have to be in this together.
Brandt, René (2009). The mental health of people living with HIV/AIDS in Africa: a systematic review. African Journal of AIDS Research, 8(2), 123–133. doi:10.2989/AJAR.2009.8.2.1.853
Collins, P. Y., Holman, A. R., Freeman, M. C., & Patel, V. (2006). What is the relevance of mental health to HIV/AIDS care and treatment programs in developing countries? A systematic review. AIDS (London, England), 20(12), 1571–1582. https://doi.org/10.1097/01.aids.0000238402.70379.d4
Remien, Robert H.a; Stirratt, Michael J.b; Nguyen, Nadiaa; Robbins, Reuben N.a; Pala, Andrea N.a; Mellins, Claude A.a Mental health and HIV/AIDS, AIDS: July 15, 2019 - Volume 33 - Issue 9 - p 1411-1420 doi: 10.1097/QAD.0000000000002227