Integrating mental health screenings into practice: The need to address anxiety in HIV care

Individuals with HIV experience fluctuating levels of distress throughout the course of HIV infection. This cross-sectional study was conducted to examine the prevalence of and associations between anxiety symptoms and sociodemographic and clinical markers that were measured using the General Anxiety Disorder 7 (GAD-7) among individuals presenting for care at an urban HIV clinic. Demographic characteristics, anxiety symptoms, and behavioral risk factors were collected through individual interviews during regular scheduled clinic visits. A total of 635 individuals participated in the study, the majority of whom was male and African American. Twenty two percent of the sample reported symptoms of moderate anxiety and 11% reported severe anxiety symptoms. Patients with severe anxiety had significantly more to drink in a week than those with moderate or mild anxiety (p<.01) and among patients who smoke, moderate and severe anxiety symptoms were higher than expected (p<.001). A pack-years analysis is being conducted and the results will be presented and discussed. There was no significant difference in engaging in risky sex behaviors among the three categories of anxiety (p=.305). Individuals with severe anxiety had higher viral loads, lower medication compliance, and CD4 cell counts (p < 0.05 for all). Given the association between anxiety and poor rates of HIV viral suppression, screening and appropriate interventions for anxiety are necessary in the HIV outpatient setting to improve outcomes.