Submitted by: Melissa Sharer AIDSTAR-One Senior Care and Support Officer, John Snow, Inc.
AIDSTAR-One is funded by the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) through USAID’s Office of HIV/AIDS, and provides rapid technical assistance to USAID and U.S. Government (USG) country teams to build effective, well-managed, and sustainable HIV and AIDS programs, and promotes new leadership in the global campaign against HIV.
“First we need ARVs, second is Duong Sinh TuNa, third is psychosocial support,” said an HIV-positive female client at an HIV clinic in Van Don, Vietnam. Her spontaneous response to a question about the needs of people living with HIV (PLHIV) includes a double dose of mental health care and support. Duong Sinh TuNa is a rhythmic poem recited during relaxation and stretching exercises hosted at the clinic she attends. It reads in part: “Breathe, meditate, relax, exercise, think positively…Healthy minds and clearer thinking help recovery.”
This client knows what she’s talking about. An individual’s well-being underpins everything she or he does. Emotional health facilitates opportunities to form relationships, to love, to work, allowing a person to continue making choices that support good physical health. The World Health Organization defines mental health as “a state of well-being in which the individual realizes his or her own abilities, can cope with the normal stresses of life, can work productively and fruitfully and is able to make a contribution to his or her community,” a definition that should inform all programs and policies targeting individuals living with HIV.
Mental health services are thus critical to a continuum-of-care approach for people living with HIV (PLHIV). A recent meta-analysis looking at depression and adherence shows a consistent relationship between depression and HIV treatment non-adherence (Gonzalez et al. 2011). Estimated rates of depression among PLHIV soar as high as 72 percent in resource-constrained countries (Adewuya et al. 2007), which threatens the consistent use of the antiretroviral therapy (ART) that keeps them alive.