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Key Findings

• People with HIV are much more likely to experience mental health or substance abuse problems than individuals in the general population.
• Most individuals with HIV who have mental health or substance abuse problems receive the treatment they need, but earlier detection and intervention would likely offset the increased medical costs they often incur.
• More than half of those receiving highly active antiretroviral therapy (HAART), the most effective treatment for HIV, did not take the medications as directed; those struggling with mental health or substance abuse problems were the least likely to comply. Screening and special interventions may help.
• Violence is common in the intimate relationships of people with HIV: A combination of substance use and violence increases the likelihood of engaging in unsafe sex.

A diagnosis of HIV affects every aspect of a person’s life. Simple awareness of the disease, as well as progression of symptoms, can precipitate new, or exacerbate existing, problems with mental health and substance abuse. In turn, such problems increase an individual’s need for health care services and interfere with his or her ability to comply with complex treatment regimens. What’s more, persons with HIV who struggle with mental health or substance abuse issues may be more likely to engage in unsafe sex and needle-sharing behaviors than others, thus increasing the risk of spreading the disease.