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HIV & TB Q4 2020

The missing link: HIV and Mental Health

Image: TB Alliance

Stephen Doughty MP


Thanks to advances in science and medicine, HIV is now a manageable chronic condition, and those who are on effective treatment have an undetectable viral load, which means they cannot pass the virus on.

However, HIV still remains heavily stigmatised. The sad fact is that HIV stigma has not really moved on since the 1980s when many millions of people were dying from AIDS. 

Stigma is slowing access to HIV treatment

Early this year, the APPG on HIV/AIDS carried out an enquiry on HIV and Mental Health. We carried out this inquiry because we wanted to look at the impact of having two stigmatised comorbid conditions – mental health and HIV – and whether the health service is set up to deal with the specific challenges that this comorbidity poses.

We know that stigma is bad for mental health, but one of the key points raised by this report is that stigma is also preventing people from accessing the treatment and care that they need. 

While the real “threat” of HIV may have lessened – not least due to huge medical advances – including that if you are undetectable and on treatment – you are untransmissable “U=U” – the “perceived” threat continues to exist through stigmatising, outdated attitudes which have a hugely detrimental impact on the effectiveness of treatment and are contributing to the increase in late diagnosis. 

Increased chances of mental health issues

People with HIV are twice as likely to experience mental health issues compared to the general population. Poor mental health can also contribute to the risk of acquiring HIV in the first place. In the latest Positive Voices report, 50% of people with HIV reported feelings of depression or anxiety on any given day (compared to 24% of the general population). Despite this increased incidence of mental health conditions for people with HIV, treatment remains largely focused on the clinical side of HIV. 

50% of people with HIV reported feelings of depression or anxiety on any given day (compared to 24% of the general population).

The current global health crisis is affecting every part of human life. COVID-19 and HIV share a number of shared risk factors, creating multiple layers of risk to mental health for people living with HIV. Without sufficient mental health support for people with HIV, treatment adherence rates will deteriorate, and infections will increase. 

As with all physical health conditions, COVID-19 is putting significant strain on mental health services which have had to adapt to current restrictions on face-to-face contact. This is having a detrimental impact on people living with HIV who are, in many cases, already suffering from social isolation.

Meeting the 2030 target

Mental health and HIV disproportionately impact the same groups of people who are marginalised such as the LGBTQ+ and Black, Asian, Minority Ethnic (BAME) communities. 

We need a renewed focus on public health, and on health inequalities in our own country too – without this, we will not only fail to tackle Covid-19, but also risk huge reversal in the fight against HIV/AIDS if we are going to meet the 2030 zero new infections target. Mental health is a crucial part of that picture which mustn’t be forgotten.

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