A clinical review published in the peer-reviewed journal LGBT Health in early June by Jaclyn M. White, M.P.H., Janna R. Gordon, and Matthew J. Mimiaga, Sc.D., M.P.H., from Harvard and the Fenway Institute in Massachusetts, indicates that there may be relief at hand for HIV-positive gay men struggling with added mental health and substance abuse issues that can add difficulty to sticking to an HIV medication regimen. White et al concluded that interventions that combine both adherence counseling with standard cognitive behavioral therapy have made some headway with participants in several recent intervention trials.

Mental health issues, as well as substance use, can lend comorbidity to HIV — that is, an additional condition that compounds the effect of a primary disease. These factors can make adherence to medication more difficult than normal, though this connection is not yet well established.

White et al pointed out that concentration problems and feelings of worthlessness and hopelessness behave as barriers to self-care behavior patterns that are required for optimal outcomes on antiretroviral therapy (ART). Optimal outcomes are measured by self-efficacy efforts; those who believe in their ability to manage their own condition are more likely to approach the 80%-plus adherence level required to thrive while living with HIV, according to White et al.

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