Among people with HIV, depression is greatly underdiagnosed and undertreated, according to a new literature review.

Publishing their findings in the Harvard Review of Psychiatry, a research team led by Gustavo C. Medeiros, MD, of the University of Texas Southwestern Medical Center in Dallas, analyzed 125 research publications on HIV and depression.

“We provide evidence-based recommendations to improve assessment and management of depressive disorders in seropositive persons,” the researchers wrote in their report.


As a whole, people with HIV have a higher risk of depression than the general population, including about two to four times the risk of major depressive disorder. What’s more, such disorders are associated with lower adherence to antiretroviral treatment, a lower CD4 count and a higher death rate among HIV-positive individuals.

It can be tricky to properly diagnose depressive disorders in people with HIV because the classic symptoms of the mental health conditions can overlap with those more directly related to the virus and its treatment. These include fatigue, insomnia and reduced appetite. Other factors influencing depressive symptoms in this population include chronic stress, HIV-related stigma and social isolation.

One study found that just 7% of people with HIV and major depressive disorder received treatment for the mental health condition.

The preferred medication-based treatment for major depressive disorder is selective serotonin reuptake inhibitors. Then there’s individual or group psychotherapy.

It’s also important to effectively treat HIV and to manage any other health conditions among people living with the virus.

"Evidence-based recommendations are available for improving the assessment and management of depression in seropositive persons, and they should be implemented in real-life practice to improve outcomes,” the study authors wrote.

To read a press release about the study, click here. 

To read the study abstract, click here.