HIV/AIDS “worried well”–When the “virus” leads to a significant illness, even in its absence

Abstract

IntroductionManagement of HIV/AIDS “worried well” people is among the most complex and challenging psychiatric problems in HIV care.ObjectivesTo provide an overview of HIV/AIDS “worried well”.MethodsLiterature review based on PubMed/Medline, using the keywords “HIV” and “worried well”.ResultsThe HIV/AIDS “worried well” are those individuals who are intensely worried about being infected with HIV, despite overwhelming evidence to the contrary. Indeed, they will rapidly return with the renewed conviction that the physician has “got it wrong” or “missed something”. So, they tend to over-utilize health care services. Seven HIV/AIDS “worried well” sub-groups have been identified: those with past sex or drug use history; those with relationship problems; the partners/spouse of those at risk; couples in individual or family life transitions; past history of psychological problems; misunderstanding of health education material; and pseudo and factitious AIDS. These patients have several striking consistencies in their presenting phenomenology and background features and usually have psychiatric problems associated. The authors will analyze all these aspects. Currently there are no guidelines to deal with this clinical condition, however cognitive-behavioral therapy along with selective serotonin reuptake inhibitors has been an effective approach. It is also important to ensure follow-up discussion to these patients, especially where unresolved life issues may cause future vulnerability in absence of intervention.ConclusionsPatients may express their concerns about HIV infection by several ways, directly or indirectly, and psychiatrists need to be aware of this reality, which causes much suffering as well as severe monetary loss.Disclosure of interestThe authors have not supplied their declaration of competing interest.