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Thirty years ago, the first cases of Human Immunodeficiency Virus (HIV) and Acquired Immunodeficiency Syndrome (AIDS) garnered the world’s attention. Since then, the lives of people living with HIV/AIDS (PLWHA), their families, communities, and the society as a whole are all affected by the HIV/AIDS pandemic. Not only does HIV/AIDS elicit detrimental physical manifestations but psychosocial health is affected negatively as well in PLWHA. Since the discovery of the Highly Active Antiretroviral Therapy (HAART) in the mid-nineties, PLWHA have overcome the fear of what previously was a certain death sentence. Their life expectancy, as a result of HAART, is now approaching that of the general population (The Antiretroviral Therapy Cohort Collaboration, 2008). However, many PLWHA confront a broad range of challenges that are multiple and chronic in nature. These challenges may yield adverse psychosocial consequences that can lead, eventually, to substance abuse and other HIV/AIDS-risky behaviors. The discovery that one is infected with the HIV is associated with reduced psychosocial health in China, the United States (U.S), and South Africa (Freeman et al., 2007; Sun, 2007; Vanable, 2006). Studies show that PLWHA have complicated histories including substance abuse, mental illness, mood disorders, and social stigma (Stoskopf, 2004; Pence, 2007a; Whetten, 2006). These negative experiences have been seen across a wide range of populations including adult men and women (Kelly, 1993), men who have sex with men (MSM) (Martin, 1998, Strathdee, 1998), HIV-positive adults (Kelly, 1993), minority women (Champion, 2002), substance users (Camacho, 1996), gay and bisexual men (Rogers, 2003), adolescents, and young adults (Ramrakha, 2000). Furthermore, these negative experiences have been associated with psychosocial disorders which in turn can contribute to increased substance abuse and HIV/AIDS-risky behaviors among PLWHA (Pence, 2007b; Leserman, 2003; Tucker, 2003). Similarly, substance abuse can contribute to numerous problems for PLWHA. For example, alcohol abuse can modify liver drug metabolism, thus complicating treatment for patients with HIV/AIDS hepatitis C virus co-infection as alcohol may

Triple Challenges of Psychosocial Factors, Substance Abuse, and HIV/AIDS Risky Behaviors in People Living with HIV/AIDS