Health care professionals determining the best course of action to help prevent human immunodeficiency virus (HIV) rates from rising may be seeking information on the factors that can affect negative outcomes. One factor that may play a large role in HIV development outcomes, and one that may be leveraged to help increase preventive measures, is mental health.
A patient’s struggles with mental health may play a large role in their likelihood to take preventative measures for HIV, and may even influence other people’s likelihood as well. A 2021 study published in the Journal of the International Aids Society examined how mental health affects HIV prevention and how focusing on mental health can help with intervention.¹ What were the researchers’ findings?
The researchers examined 50 studies relating mental health and HIV prevention, and among their findings was that depressive symptoms often played a role in preventive behaviors. Patients with depressive symptoms at risk for HIV may be less likely to adhere to their pre-exposure prophylaxis (PrEP), and depressive symptoms and severe depression may have an association with less frequent use of condoms. Symptoms of anxiety, childhood trauma, and substance use are all also seen as potential indicators of lower PrEP adherence.
Not all studies examined by the researchers suggested depressive symptoms correlated with PrEP adherence, however. Health care professionals with sexually active patients with depressive symptoms will need open and honest conversations to determine the best course of action for adhering to PrEP.
Mental Health and HIV Testing
In addition to depressive and anxiety symptoms potentially making patients less likely to take preventive measures, the researchers found that they also may make it less likely that patients that meet this criteria will get tested for HIV. Having fewer depressive symptoms was associated with a higher likelihood of getting tested for HIV and other sexually transmitted infections (STIs).
Parental Mental Health
One mental health element patients may not consider when discussing HIV prevention is parental mental health. The researchers found that parental mental health outcomes may relate to HIV risk and preventive behaviors in adolescents. Improved communication about sexual health and safety precautions may not just improve the relationship, but potentially help both adolescent and parental mental health as well. The researchers suggest that these improvements in communication may reduce sexual risk behaviors.
Mental Health Service Integration
Integrating mental health services into HIV prevention education has shown promise in both reducing risk behaviors for HIV and improving mental health outcomes. These programs can potentially increase testing referrals while educating at-risk individuals on how best to prevent HIV and access mental health support.
The researchers concluded that more is needed to address HIV prevention for patients with mental health conditions, which are associated with worse prevention outcomes. Finding partners in the community to assist with the creation of interventional resources may be beneficial in increasing prevention education.
Collins PY, Velloza J, Concepcion T, et al. Intervening for HIV prevention and mental health: a review of global literature. J Int AIDS Soc. 2021;24 Suppl 2(Suppl 2):e25710. doi:10.1002/jia2.25710