Antiretroviral therapy (ART) has helped many nations significantly reduce AIDS-related mortality, but several physical and mental side effects continue to be of major public health concern.
In a recent report, UNAIDS and the World Health Organization (WHO) emphasized the significance of linking social protection programs to HIV and mental health services as well as other interventions for those with the virus and other vulnerable groups.
According to a study that was published in the American Journal of Managed Care, patients with HIV are more likely to adhere to their treatment regimens when they have access to mental health care.
The results show that relative to both those who received MHCS and those who reported not needing services, people living with HIV who report needing but not receiving MHCS are considerably more likely to report nonadherence with HIV medication.
In fact, the majority of healthcare professionals concur that improving the continuity of care and general health status of HIV/AIDS patients depends on the integration and coordination of primary and mental health care.
Little research has been done on the systems-level network integration of services in AIDS care, even while some research has looked at initiatives intended to coordinate services for persons living with HIV.
While mortality from AIDS has been largely controlled in many countries through the use of antiretroviral therapy (ART), many physical and neuropsychiatric complications remain the focus of serious health concerns.
As a universal human right that is inseparable from other public health concerns, mental health is especially crucial for those who are HIV-positive or at high risk of contracting the virus.
Though complicated, there is a connection between HIV and psychiatric problems. HIV can exacerbate the already weakened coping mechanisms of the mentally ill; on the other hand, mental illness can influence risk behaviours and raise the probability of HIV infection.
Additionally, those who are HIV + risk social stigma, ongoing physical suffering, sickness, and even death.
Co-morbidities may also prevent the use of medical services and raise the physical and mental demands on formal and informal carers. Psychiatric comorbidities are also linked to worse adherence to ART (antiretroviral medication), which results in virologic and immunologic failure.
Numerous researches have examined the connection between mental health issues and HIV prevention outcomes, demonstrating that signs of mental illness and distress are linked to higher levels of sexual risk-taking and ineffective HIV preventive efforts.
According to research, adding a mental health component to behavioural change interventions or connecting mental health services to multiple preventive measures dramatically reduced risky behaviour and mental suffering while also increasing access to mental healthcare.
Mental health conditions (MHCs) are frequently ignored, which can have a negative impact on physical health and negatively affect the quality of life. The effects of deprivation may intensify this.
Human immunodeficiency virus carriers are more likely to experience MHCs, which, if left untreated, can lead to health and psychosocial difficulties.
Numerous studies have revealed that PLWH has mental health illnesses at higher rates than the general population. For instance, a 1996 U.S. multi-site research involving slightly over 2,800 PLWH found that 15.8 percent had generalized anxiety disorder and 36% had serious depression.
In the general population of the US, there are 6.7 percent cases of severe depression and 2.1 percent cases of generalized anxiety disorder. Other North American researchers have found that PLWH has a greater incidence of mental health issues.
According to a 2014 study that used accessible electronic medical records from Ontario, Canada, the prevalence of any mental health issue was found to be 22% among non-HIV-infected people and 41% among PLWH.
In another study, HIV testing was done on more than 1,000 patients who were seeking mental health treatment at community mental health clinics, intensive case-management programs, and university-based psychiatric inpatient units.
They discovered that 4.8% of people had verified positive HIV testing, which is significantly more than the US population’s overall rate of HIV prevalence. Furthermore, data from around the world show that PLWHs have a higher incidence of mental health illnesses than the general population.
In the context of HIV, mental illness decreases adherence to antiretroviral medication (ART) and pre-exposure prophylaxis (PrEP), raises the chance of virologic failure in people who are HIV-positive, and increases the likelihood of engaging in HIV transmission risk behaviours.
People living with HIV (PLWH) may therefore be at an elevated risk for developing a variety of mental health and neurological diseases as a result of its psychological and biological impacts.
Improved medical and mental health outcomes in medically complicated patients, including HIV-infected individuals, have been seen with integrated models of care combining mental health and other health care specialists.
The involvement in HIV care and greater adherence to ART has undoubtedly been assisted by improvements in patients’ access to mental therapies.
Additionally, it has been demonstrated that patients may be less likely to drop out of care when services are co-located or when links to other resources are made clear.
The ability to access services in one location or the provision of navigation between non-collocated services may require less planning on the part of the client and lessen the toll that healthcare takes on the lives of people with complex needs, such as those who are HIV-positive and have an addiction and mental health issues.
HIV-infected patients’ complex clinical demands necessitate extensive, integrated, ongoing, and culturally sensitive treatment services.
Despite this assurance, there are still generally few interventions and methods for combining HIV and mental health services.
There is a clear need for increased mental health screening and mental health therapy to be integrated into ongoing HIV care given the compelling evidence linking behavioural and mental health issues to poor HIV health outcomes.
According to the World Health Organization (WHO), to overcome the overall treatment gap, more than a million additional mental health professionals are required (i.e., the disparity between the number of individuals who need mental health treatment and those who receive it).
A possible approach to address those demands has been identified as task-sharing, or the transfer of responsibilities often undertaken by specialist health experts to general health practitioners and community workers.
Task sharing is linked to better screening results and disease outcomes, less stigma surrounding specialized treatment, and fewer people dropping out during the referral process.
The growing number of community and primary care workers who are trained to provide pre-and post-test HIV counselling are armed with the knowledge and connections necessary to address minor psychological discomfort in this population and refer them to mental health services.
There are numerous mental health screening instruments available that are used in clinical care and research and have been validated in many parts of the world, including low- and middle-income nations.
Additionally, given the paucity of research on mental health perceptions in HIV prevention and treatment contexts especially in low- and middle-income countries (LMICs), it is important to critically examine the factors that either facilitate or hinder MSMs’ access to and utilization of mental health and psychosocial support (MHPSS).
People who are at risk for HIV and those who already have HIV have higher rates of mental health issues, which can range from distress to SMI. Such mental health issues are linked to HIV acquisition and unsuccessful HIV treatment results.
We have effective therapies and necessary assessment (screening) instruments. To close the current gap, we must prioritize mental health treatment and provide the necessary resources.
Integrating mental health care into primary care has come a long way in the HIV environment. In all HIV testing and treatment settings, these need to be ramped up much more.
HIV programs need to acknowledge that the goal of a world free of HIV cannot be achieved without incorporating mental health across all HIV programs, and preventive and care settings, as we work to continue the fight against HIV and AIDS.
The situation calls for the HIV response to be based on evidence-informed mental healthcare and to embrace the variety of experiences and tactics that help to enhance the lives and general well-being of all people around the world. To manage HIV responses and cases connect with us to schedule a free live demo