Official websites use. Share sensitive information only on official, secure websites. However, populations at risk of HIV also face overlapping vulnerabilities to common mental disorders and severe mental illness. We conducted a narrative review of the literature on HIV prevention among key populations and other groups vulnerable to HIV infection to understand the relationship between mental health conditions and HIV prevention outcomes and summarize existing evidence on integrated approaches to HIV prevention and mental healthcare.
We searched five databases for studies published from January to August , focused on HIV prevention and mental health conditions among key populations and individuals with serious mental illness. Studies were included if they evaluated an HIV prevention intervention or assessed correlates of HIV risk reduction and included assessment of mental health conditions or a mental health intervention. We identified 50 studies meeting our inclusion criteria, of which 26 were randomized controlled trials or other experimental designs of an HIV prevention intervention with or without a mental health component.
Behaviour change interventions were the most common HIV prevention approach. A majority of studies recruited men who have sex with men and adolescents. Two studies provided distinct approaches to integrated HIV prevention and mental health service delivery. Overall, a majority of included studies showed that symptoms of mental disorder or distress are associated with HIV prevention outcomes e. In addition, several studies conducted among groups at high risk of poor mental health found that integrating a mental health component into a behaviour change intervention or linking mental health services to combination prevention activities significantly reduced risk behaviour and mental distress and improved access to mental healthcare.
Evidence suggests that mental health conditions are associated with poorer HIV prevention outcomes, and tailored integrated approaches are urgently needed to address overlapping vulnerabilities among key populations and other individuals at risk. Among key populations and other vulnerable groups, the same inequities that drive HIV infection also increase the risk for mental health conditions [ 11 ].
Social exclusion and marginalization, poverty, violence and discrimination create cycles of vulnerability to both HIV and worsening mental health status [ 12 ]. A review of the mental health of sexual minorities reported elevated rates of depression, bipolar disorder, suicide attempts and drug use disorders across sexual orientation and genders [ 13 ].
