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January 10, 2007

Psychosocial Aspects of HIV Treatment

Author Affiliations

Letters Section Editor: Robert M. Golub, MD, Senior Editor.

JAMA. 2007;297(2):157-158. doi:10.1001/jama.297.2.157-b

To the Editor: In their Special Communication on the treatment of adult human immunodeficiency virus (HIV) infection, Dr Hammer and colleagues1 did not mention the significant psychosocial aspects of this disease. Evaluation and management of psychiatric, neuropsychiatric, and substance abuse problems is essential in the successful treatment of HIV/AIDS. Recognizing the mental health-related manifestations of HIV is often complicated by the complex interaction of psychosocial and biological factors. A wide spectrum of psychiatric disorders has been associated with HIV: mood, anxiety, cognitive, psychotic, personality, sleep, sexual, and substance use disorders.2 Estimates of lifetime and past-year prevalence of psychiatric disorders in individuals with HIV/AIDS are as high as 68% to 89%.3 The percentage of HIV-positive patients with any cognitive impairment during the course of their illness is 38.8% to 54.4% overall, and for those meeting full criteria for dementia is 10.4% to 25.2%.4

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