1. Capacity to screen and treat mental health and substance use disorders at HIV treatment sites in low- and middle-income countries
Angela Parcesepe1,2, Catrina Mugglin3, Matthias Egger3, Fred Nalugoda4, Charlotte Bernard5,6, Evy Yunihastuti7, Stephany Duda8, C. William Wester9, Denis Nash2, for the IeDEA Collaboration
1HIV Center for Clinical and Behavioral Studies, Columbia University and New York State Psychiatric Institute; 2City University of New York, Institute for Implementation Science in Population Health; 3University of Bern, Institute of Social and Preventive Medicine; 4Rakai Health Sciences Program; 5INSERM, Centre INSERM, Bordeaux Population Health; 6University of Bordeaux, School of Public Health; 7Universitas Indonesia/Cipto Mangunkusumo Hospital, Faculty of Medicine; 8Vanderbilt University; 9Vanderbilt University School of Medicine

2. Mental health and substance use disorders among PLWH
Mental health and substance use disorders (MSUDs) are among the most prevalent comorbidities among PLWH globally and are consistently associated with suboptimal HIV treatment outcomes
Integrating services to screen and treat MSUDs in HIV care has been advanced as a promising strategy to improve mental health and HIV treatment outcomes
Study objective: To assess practices for screening and treatment of MSUDs in HIV treatment settings in LMICs participating in the International Epidemiology Databases to Evaluate AIDS (IeDEA) consortium
Sample: 95 HIV treatment sites in 29 LMICs
Uthman et al., 2014, Curr HIV/AIDS Rep; Mayston et al., 2012; AIDS; Kaaya et al. 2013, PLoS Med

3. Combined availability of screening and on-site treatment
Percent

4. Findings and Implications
Most HIV treatment sites surveyed reported some integration of MSUD services.
Screening for PTSD was less commonly reported than screening for depression or SUDs.
Screening and on-site treatment was most commonly reported for depression as compared to PTSD or SUDs.
Future work should assess modifiable barriers and facilitators to integration of MSUD care into HIV care settings in LMICs.
Identification and evaluation of optimal implementation strategies to scale and sustain integrated MSUDs and HIV care is needed.
Data will inform the design of prospective, cohort studies to improve screening and treatment of MSUDs among PLWH in LMICs.

5. Acknowledgements Collaborators Charlotte Bernard Stephany N. Duda
Matthias Egger
Catrina Mugglin
Fred Nalugoda
Denis Nash
C. William Wester
Evy Yunihastuti
PEPFAR-NCD Project
International epidemiology Databases to Evaluate AIDS (IeDEA) Consortium
Executive Committee (Chairperson: Annette Sohn)
Site Assessment Working Group Co-Chairs: Denis Nash, Stephany Duda and C. William Wester
Mental Health Working Group
IeDEA Regional PIs / teams
Funding: The International Epidemiology Databases to Evaluate AIDS (IeDEA) is supported by the U.S. National Institutes of Health’s National Institute of Allergy and Infectious Diseases, the Eunice Kennedy Shriver National Institute of Child Health and Human Development, the National Cancer Institute, the National Institute of Mental Health, and the National Institute on Drug Abuse: Asia-Pacific, U01AI069907; CCASAnet, U01AI069923; Central Africa, U01AI096299; East Africa, U01AI069911; NA-ACCORD, U01AI069918; Southern Africa, U01AI069924; West Africa, U01AI This research was also supported by NIMH center grant (P30-MH43520; PI: Robert H. Remien), NIMH training grant (T32 MH (PI; Theodorus Sandfort), NIAID center grant P30 AI (Tennessee Center for AIDS Research), and NCATS grant UL1 TR (Vanderbilt Institute for Clinical and Translational Research). This work is solely the responsibility of the authors and does not necessarily represent the official views of any of the institutions mentioned above.