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Background <p>Mental health conditions undermine HIV treatment outcomes, yet evidence from routine care settings in rural Zimbabwe remains limited.</p> Aim <p>To examine the association between documented mental health disorders and retention in care and viral suppression among adults receiving antiretroviral therapy (ART) at a rural hospital in central Zimbabwe.</p> Methods <p>This retrospective cohort analysis used routinely collected clinical data to examine associations between documented mental health disorders and retention in care and viral suppression among adults living with HIV receiving ART. Sixty-four adults with comorbid HIV and documented mental health disorders were included as cases and matched 1:1 by age (± 1 year), sex, and duration on ART (± 1 year) to 64 adults without documented mental health disorders or other chronic treatment-related conditions, resulting in a total analytic sample of 128 participants. Ficher’s exact test and ordered logistic regression models were used to assess associations between mental health disorders and treatment outcomes, adjusting for relevant demographic covariates.</p> Results <p>The overall prevalence of documented mental health disorders (predominantly psychosis and anxiety) in this study population was low (3.6%), indicating potential underdiagnosis in routine HIV care. Documented mental health disorders were significantly associated with poorer retention in care and lower rates of viral suppression compared with controls (<i>p</i> &lt; 0.05, respectively), with psychosis and suicidality particularly associated with non-retention.</p> Conclusion <p>The findings highlight the need to strengthen mental health integration within HIV care. Targeted interventions for high-risk groups, systematic mental health screening, improved HIV-mental health data integration, and task-shifting to trained non-specialist health workers may improve clinical decision-making and support adherence, retention in care and viral suppression in similar resource-limited settings.</p>

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Association between documented mental health disorders and HIV treatment outcomes among adults receiving antiretroviral therapy in rural Zimbabwe

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年5月20日

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  • Laston Gonah,
  • Jacqueline Nyamadzawo

摘要

Background

Mental health conditions undermine HIV treatment outcomes, yet evidence from routine care settings in rural Zimbabwe remains limited.

Aim

To examine the association between documented mental health disorders and retention in care and viral suppression among adults receiving antiretroviral therapy (ART) at a rural hospital in central Zimbabwe.

Methods

This retrospective cohort analysis used routinely collected clinical data to examine associations between documented mental health disorders and retention in care and viral suppression among adults living with HIV receiving ART. Sixty-four adults with comorbid HIV and documented mental health disorders were included as cases and matched 1:1 by age (± 1 year), sex, and duration on ART (± 1 year) to 64 adults without documented mental health disorders or other chronic treatment-related conditions, resulting in a total analytic sample of 128 participants. Ficher’s exact test and ordered logistic regression models were used to assess associations between mental health disorders and treatment outcomes, adjusting for relevant demographic covariates.

Results

The overall prevalence of documented mental health disorders (predominantly psychosis and anxiety) in this study population was low (3.6%), indicating potential underdiagnosis in routine HIV care. Documented mental health disorders were significantly associated with poorer retention in care and lower rates of viral suppression compared with controls (p < 0.05, respectively), with psychosis and suicidality particularly associated with non-retention.

Conclusion

The findings highlight the need to strengthen mental health integration within HIV care. Targeted interventions for high-risk groups, systematic mental health screening, improved HIV-mental health data integration, and task-shifting to trained non-specialist health workers may improve clinical decision-making and support adherence, retention in care and viral suppression in similar resource-limited settings.