HIV and Psychiatry

Mental health and HIV/AIDS are closely interlinked. Mental disorders, including substance-use disorders, are associated with increased risk of HIV infection and affect adherence to and efficacy of antiretroviral treatments. Conversely, HIV infection can increase risk for neuropsychiatric complications including stress, mood, and neurocognitive disorders. This book provides clinicians with a comprehensive evidenced-based and practical approach to the management of patients with HIV infection and co-morbid mental disorders. It provides up-to-date and clear overviews of current clinical issues, as well as the relevant basic science. Information and data from studies of different HIV groups (eg men who have sex with men) make the text relevant to a broad spectrum of clinicians, including those working with low socioeconomic status groups in high income countries and those working in the developing world. The book uses the popular format of the World Psychiatric Association s Evidence and Experience series. Review chapters summarize the evidence on the epidemiology, pathogenesis and clinical aspects of mental disorders in HIV,and interventions (both psychotherapy and psychopharmacology including drug-drug interactions). These are complemented by commentaries addressing particular facets of each topic and providing insight gained from clinical experience. Psychiatrists, psychologists and all mental health staff working with HIV-infected patients will find this book of great benefit.

Mental health and HIV/AIDS are closely interlinked. Mentaldisorders, including substance-use disorders, are associated withincreased risk of HIV infection and affect adherence to andefficacy of antiretroviral treatments. Conversely, HIVinfection can increase risk for neuropsychiatric complicationsincluding stress, mood, and neurocognitive disorders.This book provides clinicians with a comprehensive evidenced-basedand practical approach to the management of patients with HIVinfection and co-morbid mental disorders. It provides up-to-dateand clear overviews of current clinical issues, as well as therelevant basic science. Information and data from studies ofdifferent HIV groups (eg men who have sex with men) make the textrelevant to a broad spectrum of clinicians, including those workingwith low socioeconomic status groups in high income countries andthose working in the developing world.The book uses the popular format of the World PsychiatricAssociation's Evidence and Experience series. Reviewchapters summarize the evidence on the epidemiology, pathogenesisand clinical aspects of mental disorders in HIV,and interventions(both psychotherapy and psychopharmacology including drug-druginteractions). These are complemented by commentariesaddressing particular facets of each topic and providing insightgained from clinical experience.Psychiatrists, psychologists and all mental health staff workingwith HIV-infected patients will find this book of greatbenefit.

List of Contributors ixPreface xv1 Epidemiology of Psychopathology in HIV 1Milton L. Wainberg, Karen McKinnon, and FrancineCournosCommentaries1.1 Epidemiology of Psychopathology in HIV: NeurocognitiveDisorders 34Bryan Smith and Ned Sacktor1.2 Depression and Anxiety Disorders in HIV/AIDS 40Seggane Musisi1.3 Substance Use Disorders and HIV: Evolving Syndemics 46Sheri L. Towe and Christina S. Meade1.4 Severe Mental Illness and HIV 55Etheldreda Nakimuli-Mpungu2 Pathogenesis of Mental Health Disorders in HIV 61Gursharan Chana, Chad A. Bousman, and Ian P. EverallCommentaries2.1 Behavioural and Social Risk Factors for HIV 82Landon Myer2.2 Brain Imaging and Neuro-HIV 87Christine Fennema-Notestine2.3 Host Genetics in HIV-Associated Neurocognitive Disorders93Avindra Nath and Wenxue Li2.4 Traumatic Stressors and the Psychoneuroimmunology of HIV/AIDS99Dan J. Stein, John A. Joska, and Kathleen J. Sikkema3 Clinical Aspects of HIV-Related Neurocognitive Disorders107Nicholas W.S. Davies and Bruce J. BrewCommentaries3.1 Clinical Aspects of HIV-Related Neurocognitive Disorders131Robert Paul and Jodi Heaps3.2 Differential Diagnosis in HIV-Associated NeurocognitiveDisorders 137Gabriele Arendt3.3 Psychiatric Disorders and HIV 143Glenn Treisman3.4 Optimizing the Effectiveness of HIV Treatment as Preventionwith Stimulant Users 149Adam W. Carrico4 Treatment of Psychiatric Disorders in HIV 157Maria Ferrara, Ignacio P. Valero, David J. Moore, Adam F.Knight, Nichole A. Duarte, and J. Hampton AtkinsonCommentaries4.1 Combination Anti-Retroviral Treatment and NeuroHIV 194Charles Venuto and Giovanni Schifitto4.2 Psychopharmacology and Psychiatric Co-morbidity 199Mark Halman4.3 Intervention in HIV and Psychiatry: Behavioural andPsychotherapeutic Approaches 205Reuben N. Robbins and Robert H. Remien5 Special Populations and Public Health Aspects 211Francine Cournos, Karen McKinnon, Veronica Pinho, and MiltonWainbergCommentaries5.1 Mental Health Services for HIV in Resource-Limited Settings235Crick Lund5.2 Specifying the Mental Health Context for the Development of HIVPrevention and Treatment Interventions for Men Who Have Sex withMen 240Jessica F. Magidson and Conall O'Cleirigh5.3 Following the Special Populations Home: Children and Families245Lucie Cluver, Mark Boyes, Mark Orkin, Lorraine Sherr, and MalegaKganakga5.4 Gender Issues and the Burden of Disease in Women 256Catherine Mathews and Naeemah AbrahamsIndex 263