Integrated intervention for mental health co-morbidity in HIV-positive individuals: A public health assessment.

In South Africa, where it is estimated that more people have HIV than anywhere else in the world, HIV/AIDS and psychological disorder co-morbidity have been shown both to exacerbate the late diagnosis and treatment of psychological disorders and to affect adherence to ARVs. Targeted, affordable and evidence-based strategies to reach these populations are essential. Against this backdrop, a pilot project and situational assessment aimed at determining the context of psychological care and HIV treatment services in South Africa was undertaken. The situational analysis consisted of individual interviews, a patient survey, and a retrospective medical record data review. Training and mentorship were conducted from 2011 to 2013 by the Foundation for Professional Development (FPD) in five anti-retroviral therapy (ART) clinics in the Tshwane-Metsweding area. Data were both descriptively and inferentially analysed. Outcomes indicate that the general structure of HIV services is well organised and well run in the sampled clinics. However, mental healthcare and HIV services need to be integrated further. There is also a need to develop and pilot-test appropriate materials and models for the delivery of mental healthcare within the parameters of affordability, acceptability and availability further, and to advocate the advancement of mental health and HIV treatment and policy integration.