"I Want to Live: A Qualitative Investigation of Barriers and Facilitators to ART Adherence & Mental Health Maintenance in People With HIV".

Health systems were not equipped to accommodate the unique needs of people with HIV who needed mental health treatment.

• This was identified as the first of three major themes emerging from semi-structured interviews with PWH and health professionals.
• Participants reported difficulty finding health providers who could adequately treat their unique needs as PWH.
• The study included 16 PWH and 6 health professionals who completed semi-structured interviews.
• The study was conducted in Philadelphia.

Complex mental health challenges intersected with other barriers to ART adherence and health maintenance.

• This was identified as the second of three major themes from the qualitative analysis.
• Mental health symptoms were found to hinder engagement in antiretroviral therapy (ART) adherence among PWH.
• Participants indicated that mental health made other hardships even more challenging.
• Data were collected via semi-structured interviews with n=16 PWH and N=6 health professionals.

A stable home base and community were identified as critical to health maintenance but difficult to maintain.

• This was identified as the third of three major themes from the qualitative analysis.
• Participants reported needing stable housing to maintain health, but that housing itself provided its own challenges.
• Unstable housing intersected with other barriers to both mental health treatment and ART adherence.
• This finding emerged from semi-structured interviews with 16 PWH and 6 health professionals.

Several participants suggested integrating mental health and HIV care as a potential solution to identified barriers.

• Integration of mental health and HIV care was a recommendation raised by multiple study participants.
• This suggestion emerged from both PWH (n=16) and health professionals (N=6) who were interviewed.
• The recommendation aligns with the finding that health systems were not equipped to accommodate the unique needs of PWH needing mental health treatment.
• This finding was noted in the Conclusions section of the paper.

Existing information on barriers and facilitators to mental health treatment in persons with HIV is limited.

• The authors identified a gap in the literature specifically regarding mental health treatment barriers and facilitators in PWH.
• Mental health symptoms are known to hinder engagement in ART adherence, but the specific mechanisms and most challenging aspects were not well understood.
• This gap motivated the current qualitative investigation using semi-structured interviews.
• The study recruited 16 PWH and 6 health professionals to address this knowledge gap.