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HIV

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The Massachusetts General Hospital Handbook of Behavioral Medicine

Part of the book series: Current Clinical Psychiatry ((CCPSY))

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Abstract

Though Human Immunodeficiency Virus (HIV) continues to spread around the world, advancements in antiretroviral therapy (ART) have made long-term management of the disease possible, as well as significantly reduced the risk of spreading the virus to others. However, common psychiatric/psychological conditions among HIV-infected individuals can have a detrimental impact when it comes to self-care related to the disease (i.e., medication adherence and sexual health). Furthermore, cognitive behavioral therapy (CBT) has been shown to be effective in treating these mental health conditions in the context of HIV self-care. In the first half of this chapter, we discuss the existing literature on common psychological conditions that impact individuals living with HIV, the role of these conditions in negatively affecting self-care, and the efficacy of CBT when it comes to ameliorating these psychosocial issues. We highlight depression and PTSD as key comorbid psychological conditions among this population, both of which have been linked to poor medication adherence and risky sexual behavior. In addition, we discuss the importance of targeting these areas of psychopathology in the context of HIV self-care, which research has shown can improve medication adherence and sexual risk above and beyond traditional interventions that do not address psychological comorbidities. In the second half of this chapter, we elaborate on a CBT intervention for HIV medication adherence and depression. We also include case examples throughout our discussion of the intervention to demonstrate practical applications of CBT. Finally, we end the chapter by discussing future research directions that target co-occurring psychological and health conditions for individuals living with HIV. These include the augmentation of existing CBT interventions, the dissemination of empirically based clinical tools, the use of technology to make CBT interventions easily accessible, and the integration of psychological and biomedical prevention strategies.

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Abbreviations

ART:

Antiretroviral therapy

CBO:

Community-based organizations

CBT:

Cognitive behavioral therapy

CBT-AD:

Cognitive behavioral therapy for HIV medication adherence and depression

ETAU:

Enhanced treatment as usual

MSM:

Men who have sex with men

PEP:

Post-exposure prophylaxis

PREP:

Pre-exposure prophylaxis

PTSD:

Posttraumatic stress disorder

RCT:

Randomized control trial

UAI:

Unprotected anal intercourse

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Author information

Authors and Affiliations

  1. Department of Psychology, San Diego State University, 6363 Alvarado Court, Suite 103, San Diego, CA, 92120, USA

    Aaron Blashill

  2. Behavioral Medicine Service, Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA

    Sannisha Dale

  3. The Fenway Institute, Fenway Health, 1340 Boylston St., Boston, MA, 02215, USA

    Jonathan Jampel

  4. Department of Psychology, University of Miami, 5665 Ponce de Leon Blvd., Coral Gables, FL, 33124, USA

    Steven Safren

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  1. Aaron Blashill
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  2. Sannisha Dale
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  3. Jonathan Jampel
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  4. Steven Safren
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Corresponding author

Correspondence to Aaron Blashill .

Editor information

Editors and Affiliations

  1. Department of Psychiatry Behavioral Medicine Service, Massachusetts General Hospital, Boston, Massachusetts, USA

    Ana-Maria Vranceanu

  2. Dept. of Psychiatric Oncology & Behavior, Massachusetts General Hospital Cancer Ce, Boston, Massachusetts, USA

    Joseph A. Greer

  3. Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, USA

    Steven A. Safren

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Blashill, A., Dale, S., Jampel, J., Safren, S. (2017). HIV. In: Vranceanu, AM., Greer, J., Safren, S. (eds) The Massachusetts General Hospital Handbook of Behavioral Medicine. Current Clinical Psychiatry. Humana Press, Cham. https://doi.org/10.1007/978-3-319-29294-6_11

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  • DOI: https://doi.org/10.1007/978-3-319-29294-6_11

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