Studies have found that older adults with HIV, particularly long-term survivors, have experienced deep psychological effects of the HIV/AIDS epidemic. The effects include higher rates of depression and anxiety, increased substance use, social isolation, and cognitive impairment. Recently, there has been a focus on post-traumatic stress disorders (PTSD) in long-term survivors (LTS). PTSD in LTS often have their origins in the traumas associated with an HIV/AIDS diagnosis when there were no treatments and a diagnosis was a “death-sentence”. They woke up each day waiting for a treatment. LTS also faced losses of entire networks of friends. These stresses were compounded by the rejection of family, friends, and society as a whole that exhibited homophobia and fear of HIV/AIDS.

A PTSD diagnosis can only be done by a professional, who assess a series of criteria for the syndrome.


Re-experiencing the traumatic event(s): These may include sudden resurrection of memories, visual and otherwise, that recall the trauma underlying PTSD. These distressing memories can take many forms and are described by some as nightmares or flashbacks.

Avoiding the triggers that underly the trauma(s) to be recalled: Often someone with PTSD will try to avoid triggers that recall the trauma at all cost. People with PTSD will avoid any memories that cause them to recall and relive the traumas. They will avoid conversations or day-to-day activities associated with the traumatic events. These avoidance behaviors cause stress and anxiety as well as social isolation.

Negative thoughts and moods. People with PTSD may no longer be able to recall events and especially event details. Therefore, they are not aware that their thinking processes are often invaded by thoughts of worthlessness together with frequent emotional states of anger, fear, and shame. These negative thoughts are based on their life experiences which they no longer recall.

What you can do with your doctor

PTSD should be diagnosed by a mental health professional who is experienced with the disorder and treating it. Most treatments are short in duration.

They include:
Cognitive behavioral therapy (CBT) and cognitive processing therapy (CPT): CBT must be provided by a skilled clinician and designed to change the patterns of thinking or related behaviors that, in turn, change the negative emotions associated with the disorder.

Prolonged exposure therapy: This therapy involves confronting and re-experiencing the trauma. This must occur in a safe environment with a highly trained professional. This process causes the person to confront rather than avoid the trauma.

Eye movement desensitization and reprocessing (EMDR): This approach is designed to help the brain categorizes the traumatic memories in such a manner that the emotions associated the trauma are suppressed.

What you can do

The darkest days of the HIV/AIDS epidemic have shaped the lives of older adults with HIV, especially long-term survivors. Their experiences with loss, stigma, and fear cause painful and debilitating emotional states that can endure today. If you think you are experiencing symptoms PTSD, you should seek professional help. You should also be mindful of supporting others who might be experiencing the disorder.