The Convergence of HIV and Mental Health Issues: A Case Illustration

Mental health care is identified as an unmet healthcare need of persons living with HIV/AIDS. Psychiatric/Mental Health Nurse Practitioners, physician providers, and other health care team members may be part of an integrated care solution. Presented from the patient’s point of view, the case of a 48-year-old African American male addresses the complexities of living with HIV disease and psychiatric/mental health issues. The case is used to illustrate the convergence of HIV with major depression, anxiety, substance abuse and borderline personality disorder with prominent narcissistic and antisocial features, as well as the complex demands that chronic, comorbid physical and other mental health conditions can have on quality of life and treatment outcomes. Observations and care offered too late in his complex life by a psychiatric nurse practitioner are discussed. Many patients in acute distress and crisis, particularly those living with borderline personality disorder and other mental health issues, need to feel understood. Borderline personality disorder causes intense mood swings, impulsive behaviors, and severe problems with self-worth1. It can lead to troubled relationships in every area of a person’s life. An understanding of these issues is key to the therapeutic process.