Increases in HIV incidence associated with post-disaster depression in the New Orleans Area

Risk behaviors for contracting HIV have increased due to post-disaster related stress leading to a rise in the number of HIV cases in the New Orleans area. Depression and emotional distress are substantial influences on HIV related risk behaviors for HIV positive persons and persons who do not know their HIV status. Increased rates of depression in the New Orleans area have lead to increases in HIV related risk behavior and thus show an association to increases in HIV incidence over the past four years.

Post-disaster stressors such as environmental instability, coping with the loss of lives and property, and the breakdown of neighborhood social networks due to the exodus from the storm led to a substantial rise in rates of depression. Further, stigma within the African American community around the utilization of mental health services creates a barrier to accessing treatment for the largely minority population. In the years leading up to hurricane Katrina, the relative rate of increase (RRI) in HIV incidence was decreasing consistently from 7% in 1998 to 3% in 2003. Following the disaster in 2004, the RRI in incidence began to steadily increase from 4% in 2005 back to 7% in 2008. New Orleans residents are seven times more likely to be depressed than pre-Katrina with two-thirds of evacuees meeting the criteria for acute stress disorder. Treatment for mental health issues are severely limited due to State budget cuts as the number of mental health beds has diminished from 364 in 2004 to 133 currently.