UVa Medical Center

UVa Medical Center

Adding mental health services may improve a broad array of health outcomes for patients with HIV, according to a recent study from the University of Virginia School of Medicine.

Researchers compared how a subset of patients at UVa’s Ryan White HIV/AIDS Clinic fared before and after the clinic expanded its mental health services in 2013. UVa nearly tripled the number of clinic patients receiving mental health care, from 385 in 2012 to 1,183 in 2014, according to the study.

The study, which was published in March, compared rates of viral suppression — when HIV is undetectable in the body, a benchmark for treatment and overall health — and immune system function among one group of 130 patients who began mental health care before the expansion and 181 patients who began care after the expansion.

Researchers found that:

» patients who had access to the expanded mental health care achieved better HIV outcomes after establishing care with a mental health provider;

» patients who gained access to these services after the expansion tended to have a lower immune function and were more likely to have a detectable HIV viral load, meaning that their health was not optimized and that they could transmit HIV to someone else;

» older and white patients benefited more from the increased access to mental health care than did other patients; and

» younger and black patients were less likely to achieve viral suppression after initiating mental health care.

In their article in the journal Open Forum Infectious Diseases, the researchers expressed concern about the racial and ethnic disparities in outcomes and suggested that the clinic might need to re-evaluate how it offers treatment to younger and black patients.

In the end, the researchers concluded that access to mental health care did not significantly increase how often patients visited the clinic, but that it did seem to improve their overall health. Patients also were more likely to receive substance use diagnoses after a mental health visit, indicating increased awareness and identification of issues once the clinic had the ability to address those issues.

Expanding mental health care at HIV clinics across the country could help the U.S. reach a stated goal of viral suppression among 90% of people with HIV, they wrote.

 “It is an opportunity to improve viral suppression outcomes for vulnerable populations, and this is pressing given the worsening of the opioid and substance-use crises,” they wrote.

The study’s authors were Dr. Kathleen McManus, Raina Aggarwal, Michael Pham and Rebecca Dillingham. McManus reported stock ownership in Gilead Sciences Inc., a biopharmaceutical company that manufactures medicines for HIV and other conditions.

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