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Cited by 75HIV/AIDS Research and InterventionsHIV, Drug Use, Sexual RiskMental Health Treatment and Access

The prevalence of mental health disorders in people with HIV and the effects on the HIV care continuum

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Lang, Raynell, Hogan, Brenna, Zhu, Jiafeng, McArthur, Kristen, Lee, Jennifer, Zandi, Peter, Nestadt, Paul, Silverberg, Michael J. +15 more·2023·AIDS
DOI 10.1097/qad.0000000000003420PMC PMC9782734

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Abstract

Objective: To describe the prevalence of diagnosed depression, anxiety, bipolar disorder, and schizophrenia in people with HIV (PWH) and the differences in HIV care continuum outcomes in those with and without mental health disorders (MHDs). Design: Observational study of participants in the North American AIDS Cohort Collaboration on Research and Design. Methods: PWH (≥18 years) contributed data on prevalent schizophrenia, anxiety, depressive, and bipolar disorders from 2008 to 2018 based on International Classification of Diseases code mapping. Mental health (MH) multimorbidity was defined as having two or more MHD. Log binomial models with generalized estimating equations estimated adjusted prevalence ratios (aPR) and 95% confidence intervals for retention in care (≥1 visit/year) and viral suppression (HIV RNA ≤200 copies/ml) by presence vs. absence of each MHD between 2016 and 2018. Results: Among 122 896 PWH, 67 643 (55.1%) were diagnosed with one or more MHD: 39% with depressive disorders, 28% with anxiety disorders, 10% with bipolar disorder, and 5% with schizophrenia. The prevalence of depressive and anxiety disorders increased between 2008 and 2018, whereas bipolar disorder and schizophrenia remained stable. MH multimorbidity affected 24% of PWH. From 2016 to 2018 ( N = 64 684), retention in care was marginally lower among PWH with depression or anxiety, however those with MH multimorbidity were more likely to be retained in care. PWH with bipolar disorder had marginally lower prevalence of viral suppression (aPR = 0.98 [0.98–0.99]) as did PWH with MH multimorbidity (aPR = 0.99 [0.99–1.00]) compared with PWH without MHD. Conclusion: The prevalence of MHD among PWH was high, including MH multimorbidity. Although retention and viral suppression were similar to people without MHD, viral suppression was lower in those with bipolar disorder and MH multimorbidity.

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  • People living with HIV who also experience depression and anxiety have significantly lower retention in care compared to those without depression and anxiety.

    “People living with HIV (PLWH) who also experience depression and anxiety have significantly lower retention in care compared to those without depression and anxiety. 40”

    From Mindfulness, Mental Health, and Violence Exposure Among Transgender Female Sex Workers Living with HIV in the Dominican Republic. (2026) · cites this paper as [40]

    The Results sections on depression and anxiety report that, in adjusted models for 2016–2018, each diagnosis separately was associated with about 2% lower retention in care, with confidence intervals below 1. The claim omits that the difference was marginal and specific to the adjusted analysis; the paper reports higher annual retention for both groups in the unadjusted comparisons. It does not establish lower retention specifically for people with both depression and anxiety. (LLM, conf=0.88)

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Cited by

Sorted by citations

Authors
Lang, R., Hogan, B., Zhu, J., McArthur, K., Lee, J., Zandi, P., Nestadt, P., Silverberg, M. J., Parcesepe, A. M., Cook, J. A., Gill, M. J., Grelotti, D., Closson, K., Lima, V. D., Goulet, J., Horberg, M. A., Gebo, K. A., Camoens, R. M., Rebeiro, P. F., Nijhawan, A. E., McGinnis, K., Eron, J., & Althoff, K. N.
Affiliations
  • Johns Hopkins University (US)
  • Kaiser Permanente (US)
  • University of North Carolina at Chapel Hill (US)
  • Department of Psychiatry, University of Illinois at Chicago, Chicago, Illinois
  • University of Calgary (CA)
  • University of California San Diego (US)
  • University of British Columbia (CA)
  • Yale University (US)
  • Vanderbilt University (US)
  • The University of Texas Southwestern Medical Center (US)
  • VA Connecticut Healthcare System (US)
Corresponding author
Althoff, Keri N.
ORCID
Venue
AIDS
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2022-11-10
Volume
37
Issue
2
Pages
259-269
ISSN
  • 0269-9370 (ISSN-L)
  • 1473-5571
DOI
10.1097/qad.0000000000003420
PMC
PMC9782734
OpenAlex
W4312195937
Cited by
75
References
7
Citations by year
2026: 25 · 2025: 27 · 2024: 15 · 2023: 8
FWCI
6.11
Type
journal article
Language
en
Open access
Licence
cc-by-nc-nd
Locations
  • AIDS (publishedVersion)
  • medRxiv (acceptedVersion, cc-by-nc-nd)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
  • Carolina Digital Repository (University of North Carolina at Chapel Hill) (submittedVersion)
  • UNC Libraries
Funders
  • National Institutes of Health (n01cp001004-000, UL1TR000083, UL1TR000004, KL2TR000421, UL1TR002378)
  • National Institute on Alcohol Abuse and Alcoholism (R01AA016893, U01AA020790, U24AA020794, U01AA013566)
  • National Institute on Aging (R01AG053100)
  • National Heart, Lung, and Blood Institute (U01HL146208, U01HL146203, U01HL146242, U01HL146194, U01HL146205, U01HL146240, U01HL146333, U01HL146193, U01HL146245, U01HL146202, U01HL146201, U01HL146241, U01HL146192, U01HL146204)
  • National Institute of Mental Health (P30MH062246)
  • National Institute on Drug Abuse (U01DA036935, R01DA012568, R34DA045592, R01DA011602, F31DA037788, K24DA000432, U01DA036297)
  • National Eye Institute (U10EY008067, U10EY008052, U10EY008057, K23EY013707)
  • National Cancer Institute (N01 CP001004, N02 CP055504, Z01CP010176)
  • National Institute of General Medical Sciences (U54GM133807)
  • National Institute of Allergy and Infectious Diseases (F31AI124794, K24AI118591, U01AI069434, K01AI093197, U01AI068636, U01AI038855, U01AI038858, U01AI068634, U01AI069432, K01AI131895, K24AI065298, P30AI110527, P30AI027757, P30AI036219, P30AI094189, R24AI067039, U01AI069918, P30AI050409, P30AI050410, P30AI027763, P30AI027767)
  • National Center for Research Resources (UL1RR024131)
  • National Center for Advancing Translational Sciences
  • National Institute on Minority Health and Health Disparities (G12MD007583)
  • Eunice Kennedy Shriver National Institute of Child Health and Human Development (P2CHD050924)
Topics
  • Health Sciences › Medicine › Infectious Diseases › HIV/AIDS Research and Interventions
  • Health Sciences › Medicine › Epidemiology › HIV, Drug Use, Sexual Risk
  • Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
Keywords
HIV, mental illness, depression, anxiety, bipolar disorder, schizophrenia, HIV care continuum, retention in care, viral suppression, prevalence
MeSH terms
Anxiety Disorders, Mental Disorders, Continuity of Patient Care, Humans, Mental Health, HIV Infections, Prevalence

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