Could providing HIV patients with mental-health services improve management of their chronic illness? When the University Health System’s Ryan White HIV Clinic for patients living with HIV/AIDS received funding to expand its counseling services for mental health and substance use issues, “we thought this would be a great opportunity to see what kind of impact that change in access had on our clients,” says Kathleen McManus (Grad ’12, Res ’13), an assistant professor in the University’s School of Medicine. An important goal of HIV treatment, McManus explains, is viral suppression—having little to no HIV in the bloodstream—which allows patients with HIV to live longer and prevents transmission of the virus to others. However, HIV patients living with mental health or substance use issues have been found to have less engagement in HIV care, decreased medication adherence, and lower rates of achieving viral suppression. What wasn’t known was whether increased access to mental-health services could change that. A study by McManus and a team of researchers, published in April in the journal Open Forum Infectious Diseases, found that although gaining access to mental-health and substance-use services was not actually associated with increased client engagement in HIV care at the clinic, clients achieving viral suppression in the study group rose from 57 percent in the year before they accessed mental-health care to 88 percent in the year after. “Something that they gained through the interaction with the mental-health provider was able to lead them to have better HIV outcomes,” says McManus, who was senior author on the study, providing evidence that mental-health services can be a valuable component of effective HIV care.
Our interview with UVA’s president and provost—from a distance.