The Definition and Scope of HIV Psychiatry: How to Provide Compassionate Care

Mary Ann Adler Cohen, Jonathan Artz, Hameed Azeb Shahul, Caitlin Gonsolin, Ripal Shah, Dennis Dacarett-Galeano, Luis F. Pereira, Kelly L. Cozza

Research output: Chapter in Book/Report/Conference proceedingChapterpeer-review

Abstract

HIV psychiatry is an important aspect of psychiatry and is represented in every psychiatric specialty such as consultation-liaison psychiatry, child and adolescent psychiatry, emergency psychiatry, palliative psychiatry, and psychotherapy. HIV psychiatry is a sub-subspecialty of consultation-liaison psychiatry that focuses on the complexities of HIV prevention and care. This introductory chapter offers clinicians an overview of the nature and extent of the HIV pandemic and the definition and scope of HIV psychiatry. It gives clinicians and caregivers a clear, practical guide to psychiatric aspects of HIV care. This chapter addresses HIV stigma prevention and advocates for a model of competent, compassionate care for the psychiatric multimorbidities and manifestations of HIV and AIDS. While HIV/AIDS has become a chronic, manageable illness for people with access to HIV medical care and antiretroviral therapy (ART), there is ample evidence of an ongoing pandemic, with 36.9 million persons worldwide living with HIV, despite the fact that HIV and AIDS are entirely preventable. Three clinical vignettes convey the complex bidirectional relationship between HIV and psychiatric disorders. They underscore the importance of a comprehensive biopsychosociocultural approach to HIV/AIDS prevention, assessment, and care throughout the life cycle. The role of HIV as “The Great Magnifier” of illness and many aspects of healthcare are discussed. We explain how HIV and AIDSism magnify healthcare disparities and stigma and discrimination against persons with HIV and persons with mental illness, in both society and healthcare delivery. We describe how stigma and discrimination lead to HIV transmission and lack of access to care. In this chapter and throughout the book, we give clinicians ways to prevent HIV transmission, improve HIV care and adherence, maintain viral suppression, and provide collaborative compassionate care.

Original languageEnglish
Title of host publicationHIV Psychiatry
Subtitle of host publicationA Practical Guide for Clinicians
PublisherSpringer International Publishing
Pages1-22
Number of pages22
ISBN (Electronic)9783030806651
ISBN (Print)9783030806644
DOIs
StatePublished - 1 Jan 2021

Keywords

  • AIDS
  • AIDSism
  • Biopsychosociocultural approach
  • Collaborative care
  • HIV
  • HIV discrimination
  • HIV pandemic
  • HIV psychiatry
  • HIV stigma
  • Psychiatric illness stigma
  • The Great Magnifier
  • Viral suppression

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