COMMENTARY

Mental Health Screening in HIV: Guideline and Commentary

Francine Cournos, MD

Disclosures

June 12, 2013

In This Article

Additional Considerations

HIV-Related Triggers of Mental Distress

Clinicians should be aware of triggers that can cause mental distress, such as:

Learning of HIV status and disclosure to sex partners, family, and friends;

Physical illness, diagnosis of a sexually transmitted disease, introduction of antiretroviral medications, or AIDS diagnosis;

Hospitalization (particularly first hospitalization);

Life changes (eg, death of a significant other, end of relationship, job loss); or

Necessity of making end-of-life permanency-planning decisions.

Elements of a Psychosocial Assessment

The following assessment may help determine the need for additional support:

Stability of housing,* employment, and government assistance, and level of education

Support network and safety:

   ✓ Does the patient have contact with family and friends? Are they aware of the patient's HIV status?

   ✓ Does the patient have a partner? Is the patient afraid of his/her partner or someone else close?

Legal issues, including end-of-life arrangements

*Contact information, housing, and support network should be closely monitored for patients with unstable living situations.

Prescribing Considerations

Use of full prescribing information, knowledge of drug/drug interactions, and patient education are important components of effective psychopharmacologic treatment. Consultation with a psychiatrist experienced in HIV treatment may be warranted.

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