Thursday 5 March 2020
The All-Party Parliamentary Group (APPG) report of 5 March reflects the concerns of BHIVA clinicians regarding the failure of mental health services to meet the needs of patients with HIV. BHIVA Standards of Care, 2018, are clear in the recommendation that people living with HIV should be screened annually for mental health problems, and reviewed regularly, to identify need for specialist support. However, this can be hard to deliver, as clinicians frequently do not have a clear referral path for treatment.
The report reveals that nearly 40 per cent of HIV clinics do not have access to a psychological or mental health professional within their multidisciplinary team. This is despite a wealth of research showing the high incidence of mental health illness in people living with HIV. People living with HIV in the UK are substantially more likely than the general population to experience mental health symptoms and to be diagnosed with mental health problems (Positive Voices Survey, 2018.)
The impact of poor mental health may make it harder for people to attend clinic appointments and take their HIV treatment regularly. This in turn may lead not only to higher rates of comorbidities and mortality, but also potentially to increased transmission as the result of viral rebound.
Comments Dr Laura Waters, BHIVA Chair:
"We see the impact of poor mental health on people living with HIV all too often in clinical practice and strongly recommend a holistic approach to HIV care, with robust and effective referral pathways to specialist mental health support. As the APPG report says, there is no evidence that generic mental services are effective for people living with HIV.
"HIV stigma too often deters people from seeking professional advice, despite as many as one in five reporting suicidal ideas in the past year (Stigma Index 2015.) Specialist mental health services must be provided if we are to meet the ambitious targets set for 2030 in terms of zero new HIV infections, better quality of life for people living with HIV and preventing unnecessary deaths from AIDS."
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