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Chapter 19 - HIV and Mental Health in Men

from Section 5 - Physical and Mental Health Overlap

Published online by Cambridge University Press:  10 March 2021

David Castle
Affiliation:
University of Melbourne
David Coghill
Affiliation:
University of Melbourne
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Summary

We are almost into the fifth decade of the acquired immunodeficiency syndrome (AIDS) pandemic, and in that time the illness has gone from being a highly unpredictable series of life-threatening illnesses that is consequent upon being immune compromised with a high mortality rate to being a highly treatable one-tablet-a-day infection. This represents an enormous revolution in medical treatment. AIDS was first recognized in 1981 after early cases of kaposi sarcoma and pneumocystis carinii were reported in the USA in young immunocompromised homosexual men (David et al., 2012; Rosca et al., 2012). However, the disease has been thought to have existed since the mid-1970s (Des Jarlais et al., 1989). There then followed the AIDS pandemic of the early 1980s when the spread of the virus grew exponentially throughout the world. Since then, several breakthroughs have taken place. In 1983, a retrovirus, now called human immunodeficiency virus (HIV), was identified as the causative agent (Sharp and Hahn, 2011). This led to the synthesis of antiviral medication aimed at inhibiting enzymes unique to the virus, such as reverse transcriptase inhibitors, protease inhibitors, and most recently, integrase inhibitors. In 1996 it was shown that taking a combination of these medications called combination antiretroviral therapy (cART) provided significantly effective treatment and basically stopped viral replication and the ensuing damage to the immune system (Ghosn et al., 2018). Since the introduction of cART and with further advances in research, HIV and AIDS have become a chronic illness. There has been a significant reduction in mortality and morbidity as a result of increased viral suppression that markedly halts the disease progression and reduces the rate of human transmission, resulting in people living longer and healthier lives (Ghosn et al., 2018; David et al., 2012).

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