Abstract
Common mental disorders (CMDs) and risky alcohol use are highly prevalent among people
living with HIV, yet many do not receive treatment for these mental health problems. In
Malawi, despite a mental health policy aiming to include mental healthcare into primary
health care, many clients with HIV go unscreened and untreated for mental illnesses, indicating
missed opportunities to offer mental health care to people living with HIV. The aim of
this study was to determine the numbers and types of missed opportunities for screening
and treatment of CMDs and risky alcohol use amongst a sample of people living with HIV
attending anti-retroviral (ART) clinics in Zomba Malawi. A descriptive cross-sectional clinic
survey was used, at three ART clinics in the Zomba district. Random sampling was conducted
for all clients attending their ART clinics on specific days. The study surveyed 382
participants living with HIV. Of these participants, the majority were women (N = 247,
64.7%), and 87 (22.8%) screened positive for CMDs and/or alcohol misuse using the selfreporting
questionnaire 20 (SRQ-20) and alcohol use disorder identification test (AUDIT). Of
these, only 47 (54%) had been screened by health workers for CMDs or risky alcohol use in
the past 12 months, and 66 (76%) wanted to receive treatment. Of the total sample of 382
participants, only 92 (24%) and 89 (23%) had been screened for CMDs or risky alcohol use
by health workers. Failures by clinical officers and nurses to screen or treat CMDs and risky
alcohol use in ART clinics represent missed opportunities to address the mental health of
people living with HIV. Providing psychoeducation for staff, guidelines for screening and
managing CMDs and alcohol use, increasing human resources, and accelerating implementation
of the mental health policy in Malawi may be a few ways of improving mental health
service provision at ART clinics in Malawi.
living with HIV, yet many do not receive treatment for these mental health problems. In
Malawi, despite a mental health policy aiming to include mental healthcare into primary
health care, many clients with HIV go unscreened and untreated for mental illnesses, indicating
missed opportunities to offer mental health care to people living with HIV. The aim of
this study was to determine the numbers and types of missed opportunities for screening
and treatment of CMDs and risky alcohol use amongst a sample of people living with HIV
attending anti-retroviral (ART) clinics in Zomba Malawi. A descriptive cross-sectional clinic
survey was used, at three ART clinics in the Zomba district. Random sampling was conducted
for all clients attending their ART clinics on specific days. The study surveyed 382
participants living with HIV. Of these participants, the majority were women (N = 247,
64.7%), and 87 (22.8%) screened positive for CMDs and/or alcohol misuse using the selfreporting
questionnaire 20 (SRQ-20) and alcohol use disorder identification test (AUDIT). Of
these, only 47 (54%) had been screened by health workers for CMDs or risky alcohol use in
the past 12 months, and 66 (76%) wanted to receive treatment. Of the total sample of 382
participants, only 92 (24%) and 89 (23%) had been screened for CMDs or risky alcohol use
by health workers. Failures by clinical officers and nurses to screen or treat CMDs and risky
alcohol use in ART clinics represent missed opportunities to address the mental health of
people living with HIV. Providing psychoeducation for staff, guidelines for screening and
managing CMDs and alcohol use, increasing human resources, and accelerating implementation
of the mental health policy in Malawi may be a few ways of improving mental health
service provision at ART clinics in Malawi.
| Original language | English |
|---|---|
| Article number | e0278160 |
| Journal | PLoS One |
| Volume | 18 |
| Issue number | 2 February |
| DOIs | |
| Publication status | Published - 6 Feb 2023 |
