Mental health-related help-seeking and the role of HIV care providers: A qualitative study with people with HIV in Cameroon

Mental health disorders are common among people with HIV (PWH), and the overwhelming majority of PWH with mental health disorders do not receive evidence-based mental health care. One promising strategy to increase access to evidence-based mental health care for PWH is to integrate mental health screening and treatment for common mental disorders and unhealthy drinking into HIV care. However, little is known about how PWH view the role of HIV care providers in supporting their mental health or their experiences with mental health-related help-seeking. We conducted in-depth interviews with 30 PWH at three HIV treatment centers in Cameroon. Interviews were conducted in French or English. French transcripts were translated to English for analysis. Thematic analysis was used to identify key factors that influenced mental health-related help-seeking and respondents' preferred roles of HIV care providers. Overall, participants reported that they were less likely to seek support from medical providers for mental health compared to physical health needs. Previous positive contact with providers facilitated mental health help-seeking intentions among participants. Health facility characteristics, including limited provider availability, concerns about privacy and confidentiality, and high clinic volume were noted as barriers to mental health help-seeking at HIV facilities. Participants consistently reported that they desired positive, caring interactions with HIV care providers and clinic staff and noted that providers could play a critical role in helping PWH accept their HIV diagnosis and address HIV-related stigma and material needs. Overall, this sample of PWH in Cameroon reported that mental health-related help-seeking was limited in HIV care settings, but identified strategies that have the potential to enhance mental health related-help seeking in HIV care settings and may improve the mental health of PWH. The extent to which such strategies enhance mental health help-seeking and improve mental health should be evaluated.