By Oluwakemi Agunbiade

The findings from the recently published Positive Voices survey revealed that poor mental health continues to be an issue for people living with HIV. Of those who responded, 39% reported having at least one diagnosed mental health condition; substantially higher than in the English general public which is around 26.4%. When we factor in how key populations, such Black African and Caribbean women, are less likely to access a formal diagnosis but still experience high level of psychological distress and isolation, it highlights the extent to which people living with HIV need sufficient access to mental health support.

The conversation is not just about accessibility but also the quality of mental health support people receive. In 2021, National AIDS Trust published our ‘HIV and mental health’ report, exploring the experiences of people living with HIV when they accessed NHS Talking Therapies. We found over a third of survey respondents felt their therapist did not understand the ways HIV impacted their mental health and only 48% reported their therapist had an above average understanding of HIV.

When people living with HIV feel they must continuously explain how HIV impacts them and debunk myths when accessing mental health care, this can be understandably exhausting and potentially dissuades people from returning. Healthcare professionals are not immune to using stigmatising language which further ostracises people living with HIV for whom therapy and healthcare should be a safe space.

NHS England acted on our findings, agreeing to develop the e-learning module: ‘Breaking barriers in HIV care’. Launched last week, the module will enable therapists and other mental health support staff to improve their HIV literacy. National AIDS Trust is proud to have collaborated with the NHS England team at every step in the project, alongside ViiV and many of the people who contributed to our original findings.

Our insights helped to shape the content of the e-learning module and to use another platform to educate on language, stigma, key populations and how HIV can impact people’s mental health.

February also marks LGBT+ History Month in which we are looking back on LGBTQ+ people’s achievements in healthcare, as well as discussing the complicated relationship many LGBTQ+ people have navigating health systems. Since the 1980s, LGBTQ+ people living with HIV have had to focus on survival and navigating spaces in the healthcare system where they are othered. As the UK makes progress to reach national goals to end HIV transmissions, it is essential to not forget how homophobia, biphobia and transphobia intersects with HIV stigma and the burden this often has on people’s wellbeing. National AIDS Trust will continue to champion mental health care that recognises the needs and experiences of LGBT+ people and those living with HIV.

Struggles to access adequate mental health support is not an experience exclusive to people living with HIV. However, there are unique factors to their experience and advocacy for better mental health provision for people living with HIV is fundamental to improving their quality of life overall. To address the unmet needs of people living with HIV, mental health must be prioritised alongside physical health. Talking Therapies, as one of the most widely provided and accessed mental health services, needs to be equipped to support those living with HIV.

This e-learning module is a first step and we hope this will make way for further learning for therapists. We must also continue to work towards better referral pathways between clinics and mental health support and improve access to wider support for wellbeing, including peer support and longer-term psychiatric support where needed.

To read more about the e-learning module, you can find information on NHS England’s e-Learning For Healthcare website.