Mental Health Care in HIV Clinics Proves Beneficial

Increasing access to mental health services improves HIV outcomes among vulnerable patients, according to a new study from the University of Virginia School of Medicine (UVA).

In 2013, UVA’S Ryan White Clinic sought to expand its mental health services by increasing psychiatry and psychology services and substance-use counseling. Between 2012 and 2014, UVA more than doubled the number of clinic patients receiving mental health care counseling. Subsequently, mental health visits at the clinic increased from 385 in 2012 to 941 in 2013 and 1183 in 2014, according to the press release.

For this study, investigators compared a group of 130 patients who initiated mental health care before the expansion and another group of 181 patients who initiated mental health care after the expansion to determine whether the expansion affected access. They also evaluated the HIV outcomes of the patients in the latter group both before and after the expansion.

The following was the results of the study:

• HIV outcome: Those who had access to expanded mental health care services achieved better HIV outcomes and the rate of viral suppression increased from 57% to 88%.
• Access: After the expansion, those who recently accessed the mental health services did not do as well as those who had previously established mental health care counseling. The patients who gained access were more likely to have AIDS with a low CD4 count. They were also more likely to have a detectable viral load, meaning that their health was not optimized and they could transmit HIV to someone else.
• Race: Older, white patients benefitted from the increased access more than other patients. Younger and black patients were less likely to achieve viral suppression after initiating mental health care.
• Engagement: The expansion did not significantly change patients’ engagement in their HIV care, which was measured by attending at least 2 HIV medical appointments within a year.
• Diagnoses: After the expansion, more patients were diagnosed as having substance use-related diagnoses.

The authors concluded in explaining that expanded mental healthcare at HIV clinics across the United States could help in reaching the goal of viral suppression among 90% of the population.