Availability of screening and treatment for common mental disorders in HIV clinic settings: data from the global International epidemiology Databases to Evaluate AIDS (IeDEA) Consortium, 2016-2017 and 2020

Angela M Parcesepe; Melissa Stockton; Molly Remch; C William Wester; Charlotte Bernard; Jeremy Ross; Andreas D Haas; Rogers Ajeh; Keri N Althoff; Leslie Enane; William Pape; Albert Minga; Edith Kwobah; Mpho Tlali; Junko Tanuma; Dominique Nsonde; Aimee Freeman; Stephany N Duda; Denis Nash; Kathryn Lancaster; IeDEA Consortium

doi:10.1002/jia2.26147

Availability of screening and treatment for common mental disorders in HIV clinic settings: data from the global International epidemiology Databases to Evaluate AIDS (IeDEA) Consortium, 2016-2017 and 2020

J Int AIDS Soc. 2023 Aug;26(8):e26147. doi: 10.1002/jia2.26147.

Authors

Angela M Parcesepe^{1

2}, Melissa Stockton³, Molly Remch⁴, C William Wester⁵, Charlotte Bernard⁶, Jeremy Ross⁷, Andreas D Haas⁸, Rogers Ajeh⁹, Keri N Althoff¹⁰, Leslie Enane¹¹, William Pape¹², Albert Minga¹³, Edith Kwobah¹⁴, Mpho Tlali¹⁵, Junko Tanuma¹⁶, Dominique Nsonde¹⁷, Aimee Freeman¹⁰, Stephany N Duda¹⁸, Denis Nash¹⁹, Kathryn Lancaster²⁰; IeDEA Consortium¹

Affiliations

¹ Department of Maternal and Child Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
² University of North Carolina at Chapel Hill, Carolina Population Center, Chapel Hill, North Carolina, USA.
³ Department of Psychiatry, Columbia University, New York, New York, USA.
⁴ Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
⁵ Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
⁶ University of Bordeaux, National Institute for Health and Medical Research, Research Institute for Sustainable Development, Bordeaux Population Health Research Centre, Bordeaux, France.
⁷ TREAT Asia/amfAR, The Foundation for AIDS Research, Bangkok, Thailand.
⁸ University of Bern, Institute of Social and Preventive Medicine, Bern, Switzerland.
⁹ Clinical Research Education and Networking Consultancy, Yaounde, Cameroon.
¹⁰ Johns Hopkins University, Bloomberg School of Public Health, Baltimore, Maryland, USA.
¹¹ Department of Pediatrics, The Ryan White Center for Pediatric Infectious Disease and Global Health, Indiana University School of Medicine, Indianapolis, Indiana, USA.
¹² Groupe Haitien d''Etude du Sarcome de Kaposi et des Infections Opportunistes (GHESKIO), Port au Prince, Haiti.
¹³ Centre Medical de Suivi de Donneurs de Sang/CNTS/PRIMO-CI, Abidjan, Cote D''Ivoire.
¹⁴ Department of Mental Health, Moi Teaching and Referral Hospital, Eldoret, Kenya.
¹⁵ Centre for Infectious Disease Epidemiology & Research (CIDER), School of Public Health & Family Medicine, University of Cape Town, Cape Town, South Africa.
¹⁶ Division of the AIDS Medical Information of AIDS Clinical Care, National Center for Global Health and Medicine, Tokyo, Japan.
¹⁷ CTA Brazzaville, Brazzaville, Congo.
¹⁸ Department of Biomedical Informatics, Vanderbilt University School of Medicine, Nashville, Tennessee, USA.
¹⁹ City University of New York, Institute for Implementation Science in Population Health, New York, New York, USA.
²⁰ Department of Epidemiology, The Ohio State University, Columbus, Ohio, USA.

Abstract

Introduction: Common mental disorders (CMDs) are highly prevalent among people with HIV. Integrating mental healthcare into HIV care may improve mental health and HIV treatment outcomes. We describe the reported availability of screening and treatment for depression, anxiety and post-traumatic stress disorder (PTSD) at global HIV treatment centres participating in the International epidemiology Databases to Evaluate AIDS (IeDEA) Consortium in 2020 and changes in availability at sites in low- or middle-income countries (LMICs) between 2016/2017 and 2020.

Methods: In 2020, 238 sites contributing individual-level data to the IeDEA Consortium and in 2016/2017 a stratified random sample of IeDEA sites in LMICs were eligible to participate in site surveys on the availability of screening and treatment for CMDs. We assessed trends over time for 68 sites across 27 LMICs that participated in both surveys.

Results: Among the 238 sites eligible to participate in the 2020 site survey, 227 (95%) participated, and mental health screening and treatment data were available for 223 (98%) sites across 41 countries. A total of 95 sites across 29 LMICs completed the 2016/2017 survey. In 2020, 68% of sites were in urban settings, and 77% were in LMICs. Overall, 50%, 14% and 12% of sites reported screening with a validated instrument for depression, anxiety and PTSD, respectively. Screening plus treatment in the form of counselling was available for depression, anxiety and PTSD at 46%, 13% and 11% of sites, respectively. Screening plus treatment in the form of medication was available for depression, anxiety and PTSD at 36%, 11% and 8% of sites, respectively. Among sites that participated in both surveys, screening for depression was more commonly available in 2020 than 2016/2017 (75% vs. 59%, respectively, p = 0.048).

Conclusions: Reported availability of screening for depression increased among this group of IeDEA sites in LMICs between 2016/2017 and 2020. However, substantial gaps persist in the availability of mental healthcare at HIV treatment sites across global settings, particularly in resource-constrained settings. Implementation of sustainable strategies to integrate mental health services into HIV care is needed.

Keywords: HIV; PTSD; anxiety; depression; integration; mental health.

Publication types

Research Support, Non-U.S. Gov't
Research Support, N.I.H., Extramural

MeSH terms

Acquired Immunodeficiency Syndrome*
Ambulatory Care Facilities
Anxiety Disorders
HIV Infections* / complications
HIV Infections* / diagnosis
HIV Infections* / epidemiology
Humans
Stress Disorders, Post-Traumatic* / diagnosis
Stress Disorders, Post-Traumatic* / epidemiology
Stress Disorders, Post-Traumatic* / therapy

Abstract

Publication types

MeSH terms

Grants and funding