A Meeting of Minds: AIDS 2016

This week (from 18th to 22nd July 2016) 18 000 healthcare professionals, policy makers and social entrepreneurs have convened in Durban, South Africa for AIDS 2016, the 21st annual International AIDS conference.

Themed Access Equity Rights Now, the conference focusses on providing care for and engage with communities of marginalised people such as sex workers, men who have sex with men, young people, and transgender people.

Issues such as tackling stigma and discrimination and providing support for people living with HIV/AIDS (PLWHA) are a priority at the conference.

What’s the problem?

Across the world, developing countries are making progress in tackling the HIV epidemic. According to UNAIDS, in 2012 South Africa registered more than 450 000 new HIV infections, a significant drop from the 640 000 new infections registered in 2001. They have achieved this radical progress through the provision of antiretroviral therapy (ART) to more than 2.4 million people. The sense of hope is also founded on the breakthroughs scientists have made in the roll-out of Pre-exposure prophylaxis (or PrEP), a new class of medicines that people at very high risk for HIV can take to lower their chances of getting infected.

On the brink of the post-2015 development agenda, the picture seems hopeful. But something is missing; a dimension of HIV treatment remains in the dark.

The ‘New Beast’: Mental Illness Among People Living with HIV

In South Africa, 38% of people living with HIV have a common mental health disorder. This is more than triple the incidence of mental health conditions for the general South African population. What is shocking, is that in this era of ART, increased advocacy and knowledge of the condition, there has not been a decrease in prevalence of mental illness in people living with HIV, but a two-fold increase.

Depression, anxiety and other mental health disorders are of particular concern in patients with HIV because they can lead to:
• Poor treatment adherence
• Lower CD4 counts
• Increased viral load
• A greater chance of developing drugresistant strains of HIV

The problem is that these mental illnesses often go undiagnosed and untreated. A considerable mental health treatment gap exists because the system intervenes too late. Mental illness is seen as a medical problem to be treated, rather than a primary care problem to be prevented.

Project Khuluma: Making Mental Health a Priority

The conference will feature a number of innovative initiatives aiming to address this ‘new beast’ of mental health for PLWHA. We, at the SHM Foundation will present our live initiative - Project Khuluma, which uses SMS text messaging as a tool for increasing access to mental health support for adolescents in South Africa.

The Khuluma model facilitates interactive, closed support groups of 10 to 15 participants who are able to talk amongst themselves, with a facilitator and mentor, via mobile phone about living with HIV. The aim of the Khuluma model is to provide low-cost solutions to the mental health challenge, thus enabling clinics to provide better support to their patients.

The project is currently live in South Africa with 99 adolescent PLWHA. Over a period of 3 months, these adolescents have sent over 40 000 text messages about the problems they face in their daily lives – social stigma, isolation, loneliness, difficulties taking medication, having relationships and aspirations for the future.

The results have been highly promising. For those who have taken part in our support groups, there have been significant positive health outcomes:
• Decreased levels of anxiety and depression
• Increased levels of social support
• Decreased feelings of internalised stigma
• Increased knowledge about their health condition and how to access specific services

The findings from Project Khuluma will be presented by our team at the International HIV/AIDS Conference in Durban, July 18th-22nd.

Follow us on Twitter during the conference and beyond, @SHMFoundation, to keep up to date our findings and insights. You can learn more by visiting our website, or reading our case studies on Mesh and on the Mental Health Innovation Network.

You can also engage with us through Mesh using our Mesh discussion group.


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