Mental Health Screening in HIV: Guideline and Commentary

Francine Cournos, MD


June 12, 2013

In This Article

Mental Health Screening in HIV

Editor's Note: This guideline was prepared by the New York State Department of Health (NYS DOH) AIDS Institute HIV Clinical Guidelines Program and was originally published in graphical format as Mental Health Screening: A Quick Reference Guide for HIV Primary Care Clinicians. A text-based version was developed by NYS DOH and has been published here.


People with HIV are more likely to experience mental health symptoms than are those in the general population.[1] Depression, anxiety, PTSD, and cognitive impairment are among the most common disorders. Risk for suicide or violence may be present. Any sudden change in cognitive function, consciousness, or behavior should prompt immediate assessment for delirium caused by an acute medical complication.

The Mental Health Screening Quick Reference Guide may be used in the primary care setting to perform routine mental health assessment for HIV-infected patients.

All HIV-infected patients should receive baseline and ongoing assessment of the followinga:

  • Mental health disorders:

    • Depression (every visit)

    • Anxiety (at least annually)

    • PTSD (at least annually)

  • Cognitive function (at least annually)

  • Sleep habits and appetite (every visit)

  • Psychosocial status (at least annually)

  • Suicidal/violent ideation (every visit)

  • Alcohol and substance use (at least annually) b

aFor most patients, mental health screening requires approximately 10-20 minutes.
bAt-risk drug and alcohol users should be screened more frequently to identify escalation of present levels of use or harmful consequences from use.

The complexity of mental health diagnosis and treatment in the setting of HIV often requires a collaborative approach between primary care and mental health providers (ie, psychiatrists, psychologists, clinical social workers, and psychiatric nurse practitioners).