2. Triple Whammy—HIV, Mental Disorders, African Americans
Incidence of Mental Disorders in the United States
Mental disorders occur commonly across all segments of the US population. Approximately 15% of adults with a mental disorder also experience a concurrent substance use disorder, thereby making treatment more challenging. [Satcher 2000] For purposes of this curriculum, the most relevant categories of mental disorders among HIV-infected African Americans are mood disorders (depression and bipolar disorder), anxiety disorders (generalized anxiety disorder, post-traumatic stress disorder, and panic disorder), and the psychotic disorder, schizophrenia.
The estimated incidences of these disorders among the general US adult population are as follows: [Kessler 2005]
However, determining similarly specific estimates for the HIV-infected population is challenging. Nevertheless, investigators have endeavored to develop estimates of the percentages of people living with HIV disease who also experience mental health problems. [Hammond 2007]
Systematic analyses of the incidences of the above mental disorders among HIV-infected African Americans are not available. Nevertheless, in light of the disproportionate representation of African Americans among the HIV-infected population and the extent of under-diagnosis and misdiagnosis of mental disorders in African American communities, comorbidity of HIV disease and mental disorders is likely to be at least as significant as in the HIV-infected population as a whole.