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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

It is arguable whether the high prevalence of . . . [Full Text of this Article]

Kristin Brousseau, DO
kristin.brousseau@va.gov
VISN 19 MIRECC/Denver Veterans Affairs Medical Center
Denver, Colo

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