This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Google Scholar Articles by Whetten, K. Articles by Murphy-McMillan, L. K. PubMed PubMed Citation Articles by Whetten, K. Articles by Murphy-McMillan, L. K. Related Collections Anxiety Depression Reviews HIV/AIDS

Trauma, Mental Health, Distrust, and Stigma Among HIV-Positive Persons: Implications for Effective Care

From the Center for Health Policy, Law, and Management (K.W., S.R., R.W., L.K.M.-M.), Department of Public Policy, Duke University; Department of Community and Family Medicine (K.W., S.R., R.W., L.K.M.-M.), Duke University; and Health Inequalities Program (K.W., S.R., R.W., L.K.M.-M.), Duke University, Durham, North Carolina.

Address correspondence and reprint requests to Kathryn Whetten, Health Inequalities Program, Center for Health, Policy, Law, and Management, Department of Public Policy, Duke University; Box 90253, Durham NC 27708. E-mail: K.whetten{at}duke.edu

Individuals living with HIV often have complicated histories, including negative experiences such as traumatic events, mental illness, and stigma. As the medical community in the United States adapts to managing HIV as a chronic disease, understanding factors such as these negative experiences that may be associated with poorer adherence to treatment regimens, greater HIV risk behavior, and lower patient quality of life becomes critical to HIV care and prevention. In less wealthy nations, these issues are also critical for addressing quality of life as well as medication adherence in the areas where antiretroviral therapies are being made available. This article presents a review of the literature regarding the following psychosocial factors as they relate to HIV/AIDS in the US and globally: traumatic events; mental illness, including depression, anxiety, and posttraumatic stress disorder; lack of trust in the healthcare system and government; and experiences of stigma among individuals with HIV disease. These factors have been found to be prevalent among individuals with HIV/AIDS, regardless of gender or race/ethnicity. Traumatic events, mental illness, distrust, and stigma have also been linked with poorer adherence to medication regimens and HIV risk behavior.

Key Words: HIV • traumatic events • depression • anxiety • PTSD • adherence

Abbreviations: CHASE = Coping with HIV/AIDS in the Southeast; HCSUS = HIV Costs and Service Utilization Study.

This article has been cited by other articles:

				J. Leserman and L. R. Temoshok A Road Well Traveled (Although Not Yet a Super Highway) Psychosom Med, June 1, 2008; 70(5): 521 - 522. [Full Text] [PDF]

				A. W. Carrico and M. H. Antoni Effects of Psychological Interventions on Neuroendocrine Hormone Regulation and Immune Status in HIV-Positive Persons: A Review of Randomized Controlled Trials Psychosom Med, June 1, 2008; 70(5): 575 - 584. [Abstract] [Full Text] [PDF]

				C. Gore-Felton and C. Koopman Behavioral Mediation of the Relationship Between Psychosocial Factors and HIV Disease Progression Psychosom Med, June 1, 2008; 70(5): 569 - 574. [Abstract] [Full Text] [PDF]

				J. Leserman Role of Depression, Stress, and Trauma in HIV Disease Progression Psychosom Med, June 1, 2008; 70(5): 539 - 545. [Abstract] [Full Text] [PDF]