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HIV/AIDS and Mental Health

Overview

HIV, or human immunodeficiency virus, is the virus that causes AIDS (acquired immunodeficiency syndrome) and can be transmitted during sexual intercourse; by sharing syringes; or perinatally during pregnancy, childbirth, or breastfeeding.

HIV weakens the immune system by destroying CD4 positive (CD4+) T cells, a type of white blood cell that is important for fighting off infections. The loss of these cells means that people living with HIV are more vulnerable to other infections and diseases.

People living with HIV may be diagnosed with AIDS when they have one or more opportunistic infections (infections that occur because HIV weakens the immune system), such as pneumonia or tuberculosis, and have a very low number of CD4+ T cells (less than 200 cells per cubic millimeter of blood). For more information on HIV/AIDS, please visit the National Institute of Allergy and Infectious Diseases (NIAID) HIV/AIDS webpage.

People living with HIV/AIDS are at a higher risk for mental disorders.

The stress associated with living with a serious illness or condition, such as HIV, can affect a person’s mental health. It is important for people living with HIV to know that they have a higher chance of developing mood, anxiety, and cognitive disorders. For example, depression is one of the most common mental health conditions faced by people living with HIV. It is important to remember that mental disorders are treatable. People who have a mental disorder can recover completely.

Situations that can contribute to mental health problems for people living with HIV include:

  • Having trouble getting mental health services
  • Experiencing a loss of social support, resulting in isolation
  • Experiencing a loss of employment or worries about being able to perform at work
  • Having to tell others about an HIV diagnosis
  • Managing HIV medicines and medical treatment
  • Dealing with loss, including the loss of relationships or the death of loved ones
  • Facing stigma and discrimination associated with HIV/AIDS

HIV and related infections can also affect the brain and the rest of the nervous system. This may change how a person thinks and behaves. Also, some medications used to treat HIV may have side effects that affect a person's mental health.

Understanding how living with HIV can affect mental health and knowing what resources are available can make it easier for people to manage their overall health and well-being.

Central Nervous System Disease Associated with HIV

HIV causes significant inflammation in the body. This inflammation can cause neurological complications by damaging the spinal cord and brain, which make up the central nervous system.

Antiretroviral therapy (ART), a combination of HIV medications taken daily, helps stop HIV from replicating and spreading in the body. Despite effective ART, people living with HIV are still at risk for central nervous system diseases associated with HIV. These diseases can be neurological (affecting the nervous system) or neurocognitive (affecting cognition or mental processing).

Severe neurological impairments such as dementia, brain atrophy, and encephalitis (inflammation of the brain) are less common in people who use ART, compared to people living with HIV who are not on ART. However, there are still less severe forms of central nervous system diseases associated with HIV.

Researchers are working to better understand how HIV affects the central nervous system; this information will be helpful to develop new treatments to improve the lives of people living with HIV. Understanding which types of cells in the central nervous system are targeted by the HIV infection and how those cells are damaged may help shape efforts to prevent, treat, and cure HIV. Research efforts also focus on understanding why HIV is harder to eliminate in some tissues in the body and what strategies might be more effective on those cells.

HIV Treatments and Therapies

Research shows that HIV treatment should begin as soon as possible after diagnosis to achieve the best health outcomes. HIV treatment usually includes a combination of medicines called antiretroviral therapy (ART). Following a treatment plan, such as taking the medications prescribed by a health care provider, is critical for controlling and suppressing the virus. Following the treatment plan can be difficult, but there are strategies that can help. For more information and helpful tips, see the HIV.gov page on Taking Medication Every Day. 

Starting ART also can affect mental health in different ways. Sometimes ART can help to relieve anxiety because knowing that you are taking care of yourself can provide a sense of security. However, coping with the reality of living with a chronic illness like HIV can be challenging. In addition, some antiretroviral medicines may cause symptoms of depression, anxiety, and sleep disturbance and may make some mental health issues worse.

For these reasons, it is important for people living with HIV to talk to their health care provider about their mental health. A conversation about mental health should be part of a complete medical evaluation before starting ART, and discussions about mental health should continue throughout treatment.

People living with HIV should be open and honest with their provider about any changes in their mental health, such as thinking or how they feel about themselves and life in general. People living with HIV should also discuss any alcohol or substance use with their provider. For more information, see the HIV.gov pages on Mental Health and HIV and Alcohol and Drug Use.

People living with HIV should also tell their health care provider about any over-the-counter or prescribed medications they may be taking, including any psychiatric medicines, because some of these drugs may interact with antiretroviral medications. Learn how to get the conversation started with Tips for Talking with Your Health Care Provider.

Join a Study

Clinical trials are research studies that look at new ways to prevent, detect, or treat diseases and conditions. The goal of clinical trials is to determine if a new test or treatment works and is safe. Although individuals may benefit from being part of a clinical trial, participants should be aware that the primary purpose of a clinical trial is to gain new scientific knowledge so that others may be better helped in the future.

Researchers at the National Institute of Mental Health (NIMH) and around the country conduct many studies with patients and healthy volunteers. We have new and better treatment options today because of what clinical trials uncovered years ago. Be part of tomorrow’s medical breakthroughs. Talk to your health care provider about clinical trials, their benefits and risks, and whether one is right for you.

To learn more or find a study, visit:

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Last Revised: November 2020

Unless otherwise specified, NIMH information and publications are in the public domain and available for use free of charge. Citation of the NIMH is appreciated. Please see our Citing NIMH Information and Publications page for more information.