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HIV/mental illness link poorly recognised.

The links between HIV and mental illness are so multi-layered, and little understood, that doctors often struggle to determine which came first. Mental health care professionals sometimes battle to understand the causes of a patient's psychosis or dementia, without knowing that the patient has a late-stage HIV infection, while their colleagues in the HIV/AIDS sector have little or no training on how to deal with patients with mental illnesses.

'There are no specific mental health services for people living with HIV,' said Professor Melvyn Freeman, co-author of a study by the Human Sciences Research Council (HSRC), which found that 44% of a sample of 900 HIV-positive individuals were suffering from a mental disorder.

Mental illnesses can be risk factors for HIV. Some mental disorders lead to greater promiscuity; others can make sufferers more vulnerable to sexual abuse and exploitation. Even depression can increase an individual's HIV risk. 'If you don't feel there's much point in your own survival, you don't see the point in taking precautions to protect yourself,' noted Freeman, who has advised the UN World Health Organization on how better to integrate mental health into its HIV/ AIDS initiatives. Conversely, people with HIV are more likely to develop mental illness than the general population.

'One of our biggest challenges in psychiatry is this epidemic,' said Dr Greg Johnsson, a psychiatrist at Chris Hani Baragwanath Hospital where his team of a nurse, occupational therapist and a psychologist run a special clinic in the psychiatric section for HIV-positive patients who also suffer from mental illness. 'The goal is to treat the HIV and also treat the mental illness, because at the ARV clinics they're so overwhelmed that they don't pick up on the depressions, dementia and psychosis,' Johnsson added.
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Title Annotation:South Africa
Author:Bateman, Chris
Publication:CME: Your SA Journal of CPD
Article Type:Brief article
Geographic Code:6SOUT
Date:Aug 1, 2008
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