Mental Health Issues among PLHIV

Two weeks back, we were talking about the challenges of referring patients with mental health issues to psychiatry service. During the discussion, we mentioned how stigma and discrimination can lead to depression and suicidal ideations, especially among newly diagnosed HIV positive patients.

The process of testing itself is imbedded in a private and confidential setting, with counselling to provide psychological support when one finds out about the diagnosis. Disclosure to family and loved ones of one’s status becomes difficult, considering that one needs to open oneself up to the risk of rejection and isolation. It is painful to realize that you may not be accepted, and that you may be shunned from polite society.

I knew a prominent Filipino doctor who died of suffocation, refusing intubation. He had an opportunistic fungal pneumonia, and he wanted to die because he could not accept that he had HIV/AIDS. So he refused all interventions, and signed an advance directive to allow him to die. Had he received psychiatric help for the depressive feelings he must have had, who knows? He might have been helping the Filipino poor today, providing health service delivery.

Last week, we had a technical meeting with the Department of Health, WHO and UNICEF on the implementation of the prevention of mother to child transmission of HIV in the Central Visayas. During this meeting, we discussed the challenges of treating, caring and supporting pregnant women living with HIV and their families. There is a new administrative order being drafted which integrates prevention of mother to child transmission of HIV in all levels of healthcare. In an instant, I could imagine all the challenges we would have, so we requested that this new order be implemented with strong programs on stigma reduction and HIV awareness programs especially for healthcare providers.

During a regional forum with the Health Policy Development Program discussing the challenge of reaching the poor through a continuum of care, it was mentioned that almost 50% of people who inject drugs were HIV-positive. These people also deal with mental health issues which drove them to use drugs in the first place. How do we integrate HIV in all levels of healthcare without addressing first the basic mental health issues of key affected population – male who have sex with males, IV drug users, female sex workers?

Have you had an HIV test? Until the HIV test becomes as routine as a complete blood count, it may be difficult to encourage HIV testing at the community level, and in all levels of healthcare. We’ve got a lot of things to talk about HIV yet.

The Duke and Duchess of Cambridge and Prince Harry had a conversation about putting their Heads Together for mental health.
They realized that all their personal advocacies had the central point of mental health – that simply talking about things can already be therapeutic, like medicine. If they can do it, so can we at #HealthXPH!

  • Join us as we discuss the mental health issues among people living with HIV (PLHIV) on Saturday, July 15, 2017 at 9PM MLA / 9AM EST:
    T1. Give examples of mental health issues faced by PLHIV.
    T2. How can mental health issues affect the programmatic approach to prevent HIV/AIDS?
    T3. Suggest strategies that may help reduce stigma and discrimination among PLHIV.