HIV and Mental Health Comorbidities..pptx

HIV and mental Health comorbidities

1. HIV and Mental Health Comorbidities. BY: EMMANUEL TUMUKUGIZE. DCM, BME [email protected] [phone]/ [phone]

2. Prevalence of HIV/AIDS and Mental Health Comorbidities Prevalence of Mental Health Comorbidities : HIV infection remains a diseases of Public Health importance. Globally ,39.9M are living with HIV and 65% of these live in Africa ( WHO 2024). About 1.7 M children and adolescents are living HIV globally and 84% of these are in SSA ( UNICEF- July 2024.) The common mode of spread of HIV in Africa is through heterosexual relations: Transactional ,commercial and long term relationships- marriage. Sexual relationships between adolescent girls or young women and older men has been identified as a common route HIV spread Africa. Alliance for youths and adolescents Health Organization

3. Prevalence of HIV/AIDS and Mental Health Comorbidities Prevalence of Mental Health Comorbidities : Local situation. National prevalence is 5.4%, Females 6.8% and Males 3.9%. As of 2020, 1.4M people were living with HIV Compared to 1.2m in 2010. 29% of all new infections were AGYW despite representing 10% of the population ( Facts on HIV and AIDS in Uganda 2021) Alliance for youths and adolescents Health Organization

4. Prevalence of HIV/AIDS and Mental Health Comorbidities Prevalence of Mental Health Comorbidities : Research indicates that 44% and 58% of PLHIV globally, have mental disorders. In Africa : 10-20% of PLHIV have major depression while 20-30% have elevated depressive symptoms or minor depression- Yimer et al 2021. According to a study in south Africa, a bout 45.6% of young people living with HIV have Anxiety ,16-40.8% have major depression and 4.4% to 52.6% have depressive symptoms. ( Journal of International AIDS Society 2024). In Uganda, a 2019 study of 336 adolescents , determined that 46% prevalence of depressive symptoms- Kemisha and colleagues. Other mental disorders include Post Traumatic Stress disorder, Drug and Substance abuse and HIV induced psychosis. Neuropsychiatric manifestations-Delirium. Alliance for youths and adolescents Health Organization

5. Im plications- Relationship between Mental Health Disorders and HIV Infection . Mental Health Disorders increase the risk of HIV acquisition while HIV infection increases risk of mental health disorders. High risk sexual behavior – Bipolar Affective Disorder, Adjustment disorder, Drug and substance intoxication. Shame, discrimination and Stigma accelerate feelin gs of depression. Mental disorders negatively affect adherence to ART. Alliance for youths and adolescents Health Organization

6. Key drivers to HIV and Mental health co-morbidities in Uganda. Poverty. Drug and substance abuse. High crime rate: Rape and defilement: Domestic violence Armed conflict: ADF and LRA. Death of loved ones. Overarching challenge: According to a Lancet study (2022 ) by Francesco Di Gennaro and colleagues: Mental health needs of adolescents with HIV in Africa, m ental health services for adolescents in developing countries- difficult to access and utilize such services: 1 Psychiatric : 4-5 M adolescents and 1% of schools have mental health staff. Alliance for youths and adolescents Health Organization

7. Integrated Care Approaches for Addressing Comorbidities To effectively manage the dual burden of HIV and mental health comorbidities, integrated care approaches are essential. These approaches ensure that both physical and mental health needs are addressed in a coordinated and comprehensive manner: 1. Collaborative Care Models: Team-Based Approach: Integrate HIV care with mental health services, involving a multidisciplinary team of HIV specialists, mental health professionals, primary care providers, and social workers. Care Coordination: Use care coordinators to manage treatment plans, ensure adherence, and facilitate communication among healthcare providers.

8. 2. Co-Location of Services: Single Site Access: Provide mental health services within HIV clinics or vice versa, making it easier for PLHIV to access comprehensive care without the need for multiple appointments at different locations. Holistic Care: Address both HIV and mental health needs in one setting, promoting a holistic approach to patient care. 3. Integrated Screening and Assessment: Routine Screening: Implement routine screening for depression, anxiety, and other mental health disorders as part of regular HIV care visits. Comprehensive Assessment: Use standardized tools to assess the severity of mental health conditions and monitor changes over time.

9. 4. Psychosocial Interventions: Counseling and Therapy: Offer individual and group counseling, cognitive-behavioral therapy (CBT), and other evidence-based psychotherapies tailored to the needs of PLHIV. Support Groups: Facilitate peer support groups where PLHIV can share experiences and coping strategies for managing both HIV and mental health issues. 5. Medication Management: Medications: Prescribe medications for mental illnesses as needed, ensuring careful monitoring for interactions with ART. Adherence Support: Provide support for medication adherence through reminders, education, and addressing barriers.

10. 6. Community-Based Interventions: Outreach Programs: Conduct community outreach to raise awareness about the importance of mental health care for PLHIV and reduce stigma. Home-Based Care: Offer home-based care services for those who have difficulty accessing clinic-based services . Create awareness in Schools. 7. Training and Education: Provider Training: Train healthcare providers on the intersection of HIV and mental health, equipping them with the skills to recognize and manage comorbid conditions. Patient Education: Educate PLHIV about the signs and symptoms of mental health issues, the importance of seeking help, and available resources.

11. 8. Telehealth Services: Remote Counseling: Use telehealth platforms to provide remote mental health counseling and support, particularly for those in rural or underserved areas. Digital Monitoring: Utilize digital tools to monitor mental health symptoms and medication adherence remotely. 9. Policy and Advocacy: Integrated Health Policies: Advocate for health policies that support the integration of HIV and mental health services, ensuring adequate funding and resource allocation. Reducing Stigma: Work towards reducing stigma associated with both HIV and mental health conditions through public awareness campaigns and community education.

12. THANK YOU FOR LISTENING.