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HIV clinicians can streamline the process of detecting and addressing mental health issues by incorporating routine PTSD screening in HIV care.

HIV clinicians should routinely screen patients for PTSD and other mental health conditions, researchers advise, following their findings that show a PTSD prevalence of 13% in patients with well-controlled HIV.

“Healthcare providers (HCP) play a pivotal role in the mental health of [people with HIV] through detection, shared decision making surrounding follow-up activities, and referrals where necessary,” Marc van der Valk, MD, PhD, and colleagues wrote in the journal AIDS and Behavior. “However, some HCPs might feel they lack the training necessary to detect and triage mental health issues in [people with HIV]. This is problematic.”

Factors Associated With PTSD

The study included 474 patients with HIV who completed the Primary Care PTSD Screen for DSM-5 (PC-PTSD-5). Among them, 62 patients, or 13.1%, had clinically relevant PTSD symptoms.

“We suspect that this is an underestimation of prevalence,” the researchers wrote, “because only [people with HIV] with access to the electronic patient dossier were offered questionnaires.”

Being younger than 50 (OR, 2.29) and having been born in a low- or middle-income country (OR, 2.02) were significantly associated with PTSD, multivariable analyses found.

Role of HIV Clinicians

The ongoing relationship between HIV clinicians, often the primary healthcare contact, and their patients cultivates a trust that does not automatically extend to other healthcare providers, researchers pointed out.

“In the Netherlands, [people with HIV] report increased enacted stigma towards [people with HIV] from non-HIV HCP,” Dr. van der Valk and colleagues wrote. “This is consistent with studies from other countries where people with a migration background have reported similar experiences.”

HIV clinics can streamline the process of identifying and addressing mental health issues by introducing routine screening protocols for PTSD and other mental health conditions, the authors continued. Scores of 3 or higher on the PC-PTSD-5 assessment, while not providing a clinical diagnosis, garner further attention to determine whether a referral for PTSD treatment is appropriate.

“Through a process of shared decision making, HCP and [people with HIV] should discuss whether follow-up actions are necessary and, if so, whether informal services, such as peer support or professional mental health services, are required to address their PTSD and any other comorbid mental health issues,” the researchers wrote. “Sufficient training and support must be provided to HCP to undertake these tasks.”