Women Living with HIV in the South: How Mental Health Affects Medication Adherence and HIV Care Engagement
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Date
2023-12-05
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Authors
Cheffer, Camille
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East Carolina University
Abstract
Introduction: Barriers to HIV care engagement and ART adherence in women living with HIV (WLWH) include discrimination, HIV stigma, and mental health issues. 21% of women living with HIV report symptoms of depression creating challenges in maintaining viral suppression.
Purpose: The purpose of this secondary data analysis was to (1) describe how WLWH in the Southern United States (U.S.) perceive their mental health status influences their ART adherence and HIV care engagement and (2) describe the factors impacting their mental health, specifically depressive symptoms.
Methods: Qualitative descriptive study (N=12) using thematic analysis and secondary data from a parent study, my SHP mentor’s project titled “Modeling perceptions of social location and decision-making among women living with HIV in the South” [NIH/NINR: R21NR020164].
Results: Decreased ART adherence and/or HIV care engagement due to depressive symptoms was referenced by ten (N=10) participants. Four (N=4) women reported they were able to access mental health resources and increase their ART adherence and/or HIV care engagement. Multiple themes were identified as co-occurring factors that participants directly related to impacting their mental health. These themes were stigma/discrimination, lack of resources, lack of social support, death/trauma, and substance use disorder.
Discussion: This research addressed the gaps in the literature about women’s perceptions of how mental health affects ART adherence and HIV care engagement in the Southern U.S. Screening for depressive symptoms among all newly diagnosed WLWH can help identify a need for mental health resources and ensure early intervention. The Substance Abuse and Mental Health Services Administration (SAMHSA) identified that screening among people living with HIV (PLWH) is underused but critical. SAMHSA recommended using the Patient Health Questionnaire (PHQ-2 and PHQ-9) and the Substance Abuse and Mental Illness Symptoms Screener (SAMISS) to screen for depression in PLWH. Further research should be conducted to describe the impact of co-occurring factors leading to depressive symptoms of WLWH and to identify which interventions and mental health resources best address depressive symptoms in WLWH. The primary limitation of this research was the use of secondary data not tailored to explore the relationship between depression and ART adherence/engagement in HIV care.