Asia, the Caribbean, Latin America, sub-Saharan Africa, North America and Australia which includes the availability of screening and treatment options for depression, anxiety and PTSD. Combining the screening process, HIV treatments and HIV treatment outcomes can improve mental health and quality of life for people living with HIV. Data surrounding the availability of mental health screening and treatment centres for HIV patients are rare.
Dr. Angela Parcesepe form the University of North Carolina mentioned that the proportion of HIV treatment clinics screening for depression, anxiety and PTSD is 50%, 14% and 12%, respectively in several global regions at the 24th International AIDS conference (AIDS 2022) in Montreal last week. Locations offering the combination of screening and medication for treatment of depression, anxiety and PTSD are only available respectively at 36%, 11% and 8%.
Forty-one countries participated in the survey with a total of two hundred and twenty-three HIV treatment facilities. Sixty seven percent were in urban areas, fifty percent serviced adults and children, thirty eight percent served only adults and twelve percent only served children. Seventy-eight per cent of the facilities were in low- or middle-income countries. Trends indicated that urban clinics were most likely to report on both screening and treatment compared to the rural clinics, similarly clinics in high income countries offered mental health services.
On populations served: Clinics that served both adults and children screened more for depression (53%) than children-only clinics (31%). However, children-only clinics screened more for anxiety (23%) compared to adult and children’s clinics (13%).
On global regions: Latin America and the Caribbean clinics offered screening for depression (63%) and anxiety (13%), but no site reported screening for PTSD. In the African cohorts, east Africa screened more for depression (53%) and PTSD (14%) than other African regions but had the lowest screening for anxiety (7%). West Africa had minimal screening with depression, anxiety, and PTSD being screened at only 7%, 14%, and 7% of sites, respectively. North America surpassed all regions, screening for depression, anxiety and PTSD at 93%, 24%, and 28% of HIV treatment sites.
A survey was conducted in 2016/2017 at 68 clinics in 27 low- and middle-income countries, they compared those results with the current 2020 figures from the same 68 clinics and found that availability of depression and PTSD screening is now at 31% and 24% of clinics from that 31% didn’t offer these services in 2016/2017. Figures also show that 15% and 12% of clinics that screened for depression and PTSD in the first survey had ceased offering those services in 2020. A limitation of the study was that the availability of services was reported by facility staff and not independently verified. She also clarified that the 2020 data were collected before COVID-19, so numbers reported do not reflect decreases in services caused by the pandemic.
The lack of screening and treatment for mental health disorders in rural locations and paediatric HIV especially in low-income countries need to be identified and services are to be implemented practically and sustainably.
