Cumulative Burden of Mental Health Factors and Engagement in HIV Care in Argentina

• Published in: International journal of behavioral medicine Vol. 28; no. 3; pp. 318 - 327
• Main Authors: Sued, Omar, Cecchini, Diego, Abbamonte, John M., Rodriguez, Violeta J., Mandell, Lissa N., Cristofari, Nicholas V., Figueroa, Maria Inés, Cassetti, Isabel, Cahn, Pedro, Weiss, Stephen M., Alcaide, Maria L., Cahn, Florencia, Calanni, Liliana, Crinejo, Ana, David, Daniel, Lupo, Sergio, Pérez, Carolina, Pérez, Rufina, Rodriguez, Claudia, Rolón, María José, Sisto, Alicia, Trapé, Liliana, Jones, Deborah L.
• Format: Journal Article
• Language: English
• Published: New York Springer US 01-06-2021; Springer Nature B.V
• Subjects: Alcohol use; Drug use; Family Medicine; Full Length Manuscript; General Practice; Health Psychology; HIV; Human immunodeficiency virus; Medicine; Medicine & Public Health; Mental disorders; Mental health; Motivation; Psychosis; Public health; Substance use; Urban environments; Argentina; South America; Argentina; HIV; Comorbidities
• ISSN: 1070-5503; 1532-7558
• DOI: 10.1007/s12529-020-09921-5

Background
Cumulative burden of multiple mental health conditions may worsen physical health outcomes in vulnerable populations. Accordingly, identifying cumulative burdens of mental health conditions that may affect HIV treatment and care can guide public health strategies to reduce their impact on HIV-related health outcomes. This study examined the relationship between the cumulative burden of mental health conditions and factors associated with engagement in HIV care in Argentina.
Method
Data for this study was obtained at baseline from Conexiones y Opciones Positivas en la Argentina 2 (COPA2). Participants (
N
 = 360) were cisgender patients living with HIV who were lost to care, recruited from seven clinics serving people living with HIV in four Argentine urban centers. Cumulative burden of mental health conditions (i.e., depressive symptoms, problematic substance use, unhealthy alcohol use, and psychotic symptoms) was assessed.
Results
Every one-point increase in the number of mental health conditions present was associated with a decrement in patient-provider communication (
b
 = − 0.22,
p
 < .001), self-efficacy (
b
 = − 0.13,
p
 = .012), and motivation for adherence (
b
 = − 0.11,
p
 = .039).
Conclusion
This study found cumulative burden of depression, problematic substance use, unhealthy alcohol use, and psychotic symptoms to be negatively associated with factors related to engagement in HIV care. Results highlight the importance of identification and treatment of challenges to mental health, in order to ameliorate their influence on engagement in HIV care.