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Mental Health May Impact How Quickly Men Connect to HIV Care, Study in Cameroon Finds

January 10, 2022
Gillings School of Global Public Health
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Gillings School of Global Public Health. (Photo by Jon Gardiner/UNC-Chapel Hill)

Research conducted in Cameroon demonstrates that people living with HIV who are initiating care commonly exhibit symptoms of depression, anxiety and post-traumatic stress disorder (PTSD). What’s more, their mental health may affect how rapidly these individuals connect to HIV care to improve their health.

These findings appear in the article “Gender, Mental Health, and Entry into Care with Advanced HIV Among People with HIV in Cameroon Under a ‘Treat All’ Policy,” published in the December issue of AIDS and Behavior.

Dr. Angela Parcesepe


Lead author Angela Parcesepe, PhD, is an assistant professor in the Department of Maternal and Child Health at the UNC Gillings School of Global Public Health and a faculty fellow at the Carolina Population Center. Co-authors linked with the Gillings School are epidemiology department alumna Lindsey Filiatreau, PhD, now a postdoctoral scholar at Washington University, and Brian Pence, PhD, a professor of epidemiology.

Dr. Brian Pence


Dr. Lindsey Filiatreau


The World Health Organization recommends that all people living with HIV receive lifelong antiretroviral therapy (ART) beginning as soon as possible after diagnosis. Initiating treatment quickly has been associated with improved health outcomes for patients and reduced HIV transmission.

To understand why some individuals delay engaging in HIV care, researchers interviewed 426 people living with HIV who were newly initiating care in Cameroon between June 2019 and March 2020.

After evaluating the prevalence of depression (20%), anxiety (15%) and PTSD (12%) among interviewees, the research team assessed who enrolled in HIV care with advanced — versus early stage — HIV: 51% of men and 54% of women.

Among men, screening positive for a mental health disorder was associated with entering care with more advanced HIV symptoms — meaning men who are struggling with their mental health may wait longer to get tested for HIV or begin treatment. This finding did not hold true for women, however.

“Future research should examine gender-specific pathways between mental health symptoms and entry into care with advanced HIV, particularly for men in Cameroon,” the researchers write. “The extent to which untreated mental health symptoms drive gender disparities throughout the HIV care continuum should be explored further.”

“Enrollment into HIV care with advanced HIV remains a significant public health problem, despite national ‘treat all’ policies in which all people with HIV are eligible to receive antiretroviral therapy upon diagnosis,” adds Parcesepe. “We urgently need greater understanding of barriers to timely diagnosis and engagement in HIV care in the context of ‘treat all’ policy implementation.”

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