Let's talk: depression among people with HIV

7 April 2017 – Mental health issues, including depression are common among people living with HIV, with depression rates as high as 60% in some settings.

A staff member of the French NGO Pharmaciens Sans Frontières (PSF) meets with a client in Phnom Penh, Cambodia.
A staff member of the French NGO Pharmaciens Sans Frontières (PSF) meets with a client in Phnom Penh, Cambodia. PSF provides antiretroviral therapy and counselling, ensuring confidentiality and treatment adherence, to people living with HIV/AIDS in Phnom Penh.
© 2005 Stephane Janin, Courtesy of Photoshare

In its 2016 “Consolidated guidelines on the use of antiretroviral drugs for treating and preventing HIV infection”, WHO recommended mental health assessment and management for all people living with HIV. “This reflects the need for programmes to address this important health issue, which affects the global HIV community," said Dr Meg Doherty, WHO Coordinator for HIV Treatment and Care. "We are working with countries to adopt and implement this recommendation in an effort to provide quality person-centred care for all people living with HIV."

Lack of treatment for mental health disorders can not only affect a person's health, but also lead to poor adherence to HIV treatment. Such care is inaccessible for most people with HIV. WHO analysis on the availability of mental health services for people living with HIV showed that only 38% of national HIV programme managers reported providing mental health screening in some HIV care settings, while 43% reported not providing any mental health screening or treatment for people with HIV. None of the countries reported countrywide implementation of such care.

Many national HIV programme managers believed that integrated services for HIV and mental health are essential. However, shortages in funding, human resources, and skills and capacity of health-care providers are key obstacles in making this happen.

On World Health Day 2017, WHO underscores the importance of addressing depression among people with HIV. Without good mental health care, people with HIV may fail their treatment, which could jeopardize the outcomes of vital investments made by countries.

Many countries are making a positive policy change to implement WHO's 2016 guidelines on antiretroviral drugs, including care for depression. This gives hope that recommendations regarding mental health issues among people with HIV will be more widely implemented over the coming years.