Ikeda, Daniel J and Kidia, Khameer and Agins, Bruce D and Haberer, Jessica E and Tsai, Alexander C (2021) Roll-out of HIV pre-exposure prophylaxis: a gateway to mental health promotion. BMJ Global Health, 6, e007212. doi: 10.1136/bmjgh-2021-007212.
External website: https://gh.bmj.com/content/6/12/e007212.long
HIV remains a pressing global health problem, with 1.5 million new infections reported globally in 2020. HIV pre-exposure prophylaxis (PrEP) can lower the likelihood of HIV acquisition among populations at elevated risk, yet its global roll-out has been discouragingly slow. Psychosocial factors, such as co-occurring mental illness and substance use, are highly prevalent among populations likely to benefit from PrEP, and have been shown to undermine persistence and adherence. In this analysis, we review the high burden of mental health problems among PrEP candidates and contend that inattention to mental health stands to undermine efforts to implement PrEP on a global scale. We conclude that integration of mental health screening and treatment within PrEP scale-up efforts represents an important strategy for maximising PrEP effectiveness while addressing the high burden of mental illness among at-risk populations. As implementers seek to integrate mental health services within PrEP services, efforts to keep access to PrEP as low-threshold as possible should be maintained. Moreover, programmes should seek to implement mental health interventions that are sensitive to local resource constraints and seek to reduce intersecting stigmas associated with HIV and mental illness.
J Health care, prevention, harm reduction and treatment > Harm reduction > Substance use harm reduction
J Health care, prevention, harm reduction and treatment > Health related issues > Health information and education > Communicable / infectious disease control
J Health care, prevention, harm reduction and treatment > Type of care > Mental health care (Psychiatry / Psychology)
T Demographic characteristics > Person who injects drugs (Intravenous / injecting)
VA Geographic area > International
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