CLINICAL

• Anxiety is a common symptom that occurs in response to stressful life circumstances, but can also be a Sx of an anxiety disorder or another psychiatric disorder (such as major depression).

• Diagnosable anxiety disorders may be present in up to 40% of HIV+ pts, but prevalence of anxiety Sxs (without Dx’d disorder) even higher (up to 72%). Sxs are twice as commonly reported in women vs. men.
• Can be prominent Sx in pts first Dx’d with HIV, and in response to progression, such as declining CD4, OIs. Pts with HIV have higher exposure to traumatic events (receiving HIV Dx, sexual trauma, physical violence) than general population so at higher risk for developing PTSD (an anxiety disorder).
• Most common anxiety disorders in HIV pts are GAD and PD. 30% of HIV-positive women have PTSD which is 5x rate of general population.
• Much diagnostic overlap with other conditions. >50% of pts with anxiety disorders have comorbid depression. Alcohol use disorder also common (esp. in women).
• Anxiety can increase likelihood of HIV risk behaviors and ART nonadherence. Also, HIV+ pts. with panic disorder (PD) and post-traumatic stress disorder (PTSD) experience greater pain intensity and related dysfunction.
• Common medical conditions associated with anxiety Sx include hypoxia, stimulant intoxication, withdrawal from sedative-hypnotics, seizures, hyperthyroidism, pheochromocytoma. Anxiety can also be a side effect of EFV, interferon, or corticosteroid treatment.