Treatment - Other
Lily A. Brown, Ph.D.
Director, Center for the Treatment and Study of Anxiety
University of Pennsylvania
Philadelphia, Pennsylvania
Yiqin Zhu, M.S.
Research Assistant
University of Pennsylvania
Philadelphia, Pennsylvania
Introduction:
Persons living with HIV (PLWH) are significantly more likely to meet criteria for a psychiatric disorder compared to the general population. Despite effective modern medication to treat HIV (i.e., antiretroviral therapies, ART) and mental health treatment (i.e., cognitive behavioral therapy, CBT), adherence to HIV treatment and rates of mental health treatment utilization are generally low. It is critical to understand the barriers to ART and CBT in this high-risk sample. However, few studies have investigated the barriers to HIV and mental health treatments in PLWH. This qualitative study interviewed PLWH and care team members to examine these barriers to ART and CBT and recommendations for strategies to mitigate them.
Methods:
Participants were PLWH (n = 6) and people who have work experiences with PLWH (e.g., social worker, psychologist, infectious disease physicians, n = 4 ; 13 interviews remain to be coded). Interviews were conducted over the phone by two licensed clinical psychologists and were then professionally transcribed. Two research assistants used a codebook to conduct qualitative analysis of the transcriptions separately and then reached a consensus on codes.
Results:
The most frequently mentioned barriers to ART and mental health treatment were side effects (12), lack of motivation (10), homelessness (10), and substance use (10). Regarding the solutions to mitigate these barriers, the most frequently mentioned codes were educational resources (9) or education in general (14), professional resources (13), case manager access (5), communication with providers (4), and pharmaceutical aid programs (4) or improved access to medication in general (10).
Discussion/
Conclusion:
According to PLWH and people working with PLWH, the major barriers to ART and CBT mostly related to mental health burdens and medications themselves (e.g., pill burden and side effects), along with homelessness. Additionally, the mostly mentioned solutions were improvements and access to professional resources and education on HIV and its treatment. Clearly, in order to raise HIV treatment adherence and mental health treatment utilization rates, reformed policy for HIV care would need to address factors such as community education programs addressing stigma, mental health awareness, and equitable access to professional resources and medication.
