NEUROBIOLOGICAL, PSYCHOLOGICAL, AND SOCIODEMOGRAPHIC PREDICTORS OF MENTAL DISORDERS IN HIV INFECTION (LITERATURE REVIEW)

Abstract

Introduction. The prevalence of mental disorders among people living with HIV infection has high frequency. According to a 2022 World Health Organization report, up to 70% of people living with HIV have mental disorders such as depression, anxiety, post-traumatic stress disorder, and others. Mental disorders can reduce susceptibility to antiretroviral therapy, increase the risk of re-infection with HIV, reduce social and professional adaptation, and increase the risk of suicide and overall mortality. Materials and methods. The literature review was conducted based on published scientific research by ScienceDirect, using information and search systems PubMed and Google Scholar. А review of studies primarily from the last 5 years was conducted. Results. Depression is the leading cause of disability and is the most common HIV-related mental disorder, accounting for about 30% of people living with HIV. Large-scale meta-analyses estimate this prevalence rate is significantly higher than in the general population. Younger people with newly diagnosed HIV infection have higher anxiety levels than older patients. People living with HIV reports higher levels of mental trauma (e.g., child abuse, sexual abuse, physical abuse). The prevalence of post-traumatic stress disorders among people with HIV throughout life is 50% compared to 7% in the general population. The researchers concluded that HIV progression in HIV-infected people with post-traumatic stress disorder is twice as fast. Among the leading causes of developing mental disorders with HIV infection are neuroinflammation and neurotoxicity, psychological factors, and sociodemographic factors. HIV can make people living with HIV more susceptible to depression due to neurotoxicity, which may lead to neurotransmitter dysfunction, metabolic dysfunction, and a chronic increase in inflammatory cytokines. HIV-related stigma leads to negative consequences for the health of people with HIV. Fear of being judged by others impacts decreasing adherence to antiretroviral therapy and internalized HIV stigma provides for low adherence to antiretroviral therapy. Discussion. People living with HIV are more susceptible to developing mental disorders than the general population. Identification and research of mental disorders among people with HIV is important for improving adherence to HIV therapy. Dissemination of truthful information and educational measures about HIV can help reduce stigmatization and discrimination and improve the mental health of people living with HIV.