Integrating mental health care services into HIV comprehensive care

HIV prevention strategies prioritize medication adherence among people living with HIV (PLWH). Of the 1.1 million PLWH in the United States, more than two-fifths are not virally suppressed and thus experience increased morbidity and mortality as well as transmission risk. Integrated care models are meant to address these gaps and often cite the importance of mental health care services (MHCS). However, research into the impact of integrating MHCS has been limited to those in homogenous treatment.

This study used an analytic observational cross-sectional design to achieve the above objectives.

This study utilized a cross-sectional survey aimed to identify needs among PLWH in the Midwestern region of the United States and to stratify by both MHCS need and receipt. The survey, administered throughout 2018 in 12 HIV service organizations, was completed by PLWH receiving different supportive services. Comparative logistic regression models were calculated to identify the likelihood of nonadherence based on both MHCS receipt and need.

Of the 537 survey respondents, 20% reported receiving integrated MHCS, 8% reported needing but being unable to receive MHCS, and 72% reported not needing or receiving MHCS. Overall, 50% of the sample reported missing at least some HIV medication within the past 30 days. Individuals who needed but did not receive MHCS were more likely to report treatment nonadherence. No significant difference in adherence was identified between those who received MHCS and those who did not need MHCS.

Results suggest that continued assessment of needs and integration of MHCS into HIV care improves the likelihood of medication adherence. Further, our study highlights how systematically asking PLWH about their needs and connecting them to services may critically affect HIV management.