Queer POC, Mental Health, and AIDS
Fear and ignorance surround all epidemics, but none so much as the AIDS crisis.
Throughout the 1980s, the first cases of acquired immunodeficiency syndrome (AIDS) began to pop up among a number of already marginalized communities, including people of color and queer people. Because of the way the existing stigma that is associated with these groups intertwined with the then newfound fear of this “gay disease,” a large problem among these communities — albeit, one that is still wrongfully ignored — is the issue of mental health (APA). Substance abuse, depression, and mental illnesses resulting from AIDS complications were rampant in the 80s, and problems like these still persist to this day despite how much we have learned about this virus. Mental health issues are still more frequent among people who have contracted HIV/AIDS than in the general population, which makes this an issue of relevance not only to the time period of the epidemic but also to our current society (1).
The effect of AIDS on American society is widespread and diverse. More than 60 million people have contracted the virus since the 80s, and unsurprisingly more than half of these people have been diagnosed with a mental disorder (2, 3). Substance abuse disorder is one of the most common mental health issues among people with AIDS (4). Because a large number of victims of the AIDS epidemic are from communities of color, this association is not exactly unexpected. As a result of intersectional forces of oppression, people of color are put at a disproportionate risk for social practices that encourage the growth of these problems. Living below the poverty line, lack of sufficient education, unemployment, and unnecessary incarceration all increase the likelihood of people developing a substance abuse disorder, as well as contracting HIV/AIDS, and these are the type of conditions that people of color are constantly subject to in their daily lives (5). Alcohol use and unsafe drug practices like needle sharing have also been associated with issues that also cause other mental health issues such as having a history of physical and sexual abuse (6). One may refer to these interactions as a “perfect storm” for people of color. They are in the unfortunate position of experiencing all of these environmental factors that make them more likely to suffer from things like depression, substance use, and even HIV.
Trauma is common among people with HIV/AIDS. In fact, nearly half of all victims of the disease have been sexually assaulted (7). Assault is statistically more likely to occur among women and queer men, which makes sense for the interaction between assault, HIV, and mental illnesses, but it is also likely that these statistics are lower than in reality for straight men because of the stigma of men coming forward after sexual assault (8).
Assault has long term and harmful effects on its victims. Along with obvious physical effects, depression, PTSD, anxiety, and even borderline personality disorder are more likely among victims of assault (9). Assault, and the mental health issues it causes, makes those who have been assaulted more likely to participate in high risk behaviors. Some of these behaviors include not taking necessary medication, or even not receiving medication in general, both of which make people more likely to contract HIV, as well as to not prevent it or treat it (10). It isn’t clear what factor causes the other, but assault, mental illness, and HIV/AIDS do seem to be connected in an important way. It’s likely that it works both ways, with each factor causing each other one.
Research is severely lacking on the obvious intersections between between race and social class, and mental health, sexuality and AIDS. The issue is more than likely a lack
of diagnosis itself — people of color are historically under diagnosed for mental disorders as well as physical diseases. This lack of diagnosis happens for a number of reasons including discrimination from the side of the doctor, but also fear and distrust of the medical and psychological system itself. People of color tend to avoid medical care and psychological treatment because of a history of discrimination and medical maltreatment targeted towards specific communities of color, one of these instances including unethical testing of drugs in trials like the Tuskegee syphilis study, where black people were knowingly not treated for their disease without their informed consent (11).
While it is not widely researched, AIDS issues and mental health issues are far too common among Africans and African Americans. Thinking about the impact of AIDS transnationally is important, because Sub-Saharan Africa is by far the most affected area in the world, likely because of lack of education and access to medication (12). While transnational issues are important, it is also necessary for us to look into the experiences of Black American as they make up half of the AIDS diagnoses in North America (13). Because of the association between AIDS and mental illness, it is likely that this is a correlation among people of color as well, but this is still under researched. However, the available research does confirm this suspicion. Half of the people who have been researched in African who have contracted the virus have “some form of psychiatric disorder” (14). This shows us that this is a necessary topic to look into more, as underdiagnosis is still a huge problem and mental health issues still seem to be out of control.
Even if a number of mental health issues related to AIDS actually exist before diagnosis, mental illnesses can still be complications of the virus itself. One of these complications is dementia. Many AIDS patients experience memory loss and other symptoms like “apathy, withdrawal, muteness, tremors, incontinence, paralysis, and, in some instances, psychosis” throughout the progress of the disease (15). Because these issues are so frequent, it is important to notice their impact on the community and learn how to address them — AIDS patients must consistently stick to a medication schedule in order to prevent the progress of the virus, but with the coexisting issue of depression that is common among people with AIDS, it’s also common for people to neglect this schedule (MD Mag). This possible interaction is important to look into, so that every AIDS patient can be treated in a way that is the most helpful for them.
While dementia is still a relevant issue today, the stigma of HIV still causes problems not only for the victim of the disease but also all of the people in their lives. The fact that children of people with HIV/AIDS tend to have poorer mental development patterns than the general population just shows that HIV extends far beyond the victims of it themselves, and has a large effect on society and the people in the lives of the people with the disease (16). This idea shows that mental health research needs to be expanded to fit everyone that the disease comes into contact with.
The amount of stigma surrounding HIV and mental illness has decreased significantly within the past few years, but there is still a long way to go. Without knowledge of things like mental illness, sexuality, and HIV/AIDS, they will all continue to be topics that some people fear and hate out of complete ignorance. Education on these topics is important not only so that victims of the virus can learn to handle the progress of their disease, but also so that the stigma surrounding it can be lessened and we can all live in a world where we help those with HIV/AIDS and mental illness to progress, instead of pushing them further down.
References:
- Payesko, Jenna. “Mental Health, a Crucial Component to Ending HIV Epidemic.” MD Magazine. March 07, 2018.
- Fitzpatrick, Lisa, Eugene Mccray, and Dawn K. Smith. “The Global HIV/AIDS Epidemic and Related Mental Health Issues: The Crisis for Africans and Black Americans.” Journal of Black Psychology 30, no. 1 (February 2004): 11.
3. Payesko, “Mental Health, a Crucial Component to Ending HIV Epidemic.”
4. Brandt, René. “The mental health of people living with HIV/AIDS in Africa: a systematic review.” African Journal of AIDS Research 8, no. 2 (2009): 10.
5. Fitzpatrick, Mccray, and Smith, “The Global HIV/AIDS Epidemic and Related Mental Health Issues”, 18.
6. Whetten, Kathryn, Susan Reif, Rachel Whetten, and Laura Kathleen Murphy-McMillan. “Trauma, mental health, distrust, and stigma among HIV-positive persons: implications for effective care.” Psychosomatic medicine 70, no. 5 (2008): 531.
7. Ibid., 532.
8. Ibid.
9. Ibid.
10. Ibid., 532–533.
11. Ibid., 534.
12. Fitzpatrick et al., 11.
13. Ibid., 14.
14. Brandt, 9.
15. Giambrone, Andrew. “When HIV Infects the Brain.” The Atlantic. March 26, 2015. Accessed April 17, 2018.
16. Rie, Annelies Van, Aimee Mupuala, and Anna Dow. “Impact of the HIV/AIDS Epidemic on the Neurodevelopment of Preschool-Aged Children in Kinshasa, Democratic Republic of the Congo.” Pediatrics 122, no. 1 (July 01, 2008).
Bibliography:
Barnhart, Gwendolyn, MS. “In the Public Interest | December 2014 The Stigma of HIV/AIDS.” American Psychological Association. December 2014. Accessed April 30, 2018. http://www.apa.org/pi/about/newsletter/2014/12/hiv-aids.aspx.
Brandt, René. “The mental health of people living with HIV/AIDS in Africa: a systematic review.” African Journal of AIDS Research 8, no. 2 (2009): 1–17.
Fitzpatrick, Lisa, Eugene Mccray, and Dawn K. Smith. “The Global HIV/AIDS Epidemic and Related Mental Health Issues: The Crisis for Africans and Black Americans.” Journal of Black Psychology 30, no. 1 (February 2004): 11–23. Accessed April 16, 2018. doi:10.1177/0095798403259237.
Giambrone, Andrew. “When HIV Infects the Brain.” The Atlantic. March 26, 2015. Accessed April 17, 2018. https://www.theatlantic.com/health/archive/2015/03/when-hiv-infects-the-brain/388787/.
Payesko, Jenna. “Mental Health, a Crucial Component to Ending HIV Epidemic.” MD Magazine. March 07, 2018. Accessed April 17, 2018. http://www.mdmag.com/conference-coverage/croi-2018/mental-health-a-crucial-component-to-ending-hiv-epidemic.
Rie, Annelies Van, Aimee Mupuala, and Anna Dow. “Impact of the HIV/AIDS Epidemic on the Neurodevelopment of Preschool-Aged Children in Kinshasa, Democratic Republic of the Congo.” Pediatrics 122, no. 1 (July 01, 2008). Accessed April 16, 2018. doi:10.1542/peds.2007–2558.
Whetten, Kathryn, Susan Reif, Rachel Whetten, and Laura Kathleen Murphy-McMillan. “Trauma, mental health, distrust, and stigma among HIV-positive persons: implications for effective care.” Psychosomatic medicine 70, no. 5 (2008): 531–538.
