Use of technology for delivery of mental health and substance use services to youth living with HIV: a mixed-methods perspective

ABSTRACT

Disparities in HIV treatment outcomes among youth living with HIV (YLWH) present a challenge for ending the HIV epidemic. Antiretroviral therapy (ART) adherence can be impacted by comorbidities such as mental health and substance use. Technology use has shown promise in increasing access to mental health and substance use services. Using a mixed-methods approach, we conducted formative research to describe the relationship between mental health, substance use, and medication adherence in 18–29 year-old YLWH, and explored technology use as an approach to supporting these services. Among 101 YLWH, ART adherence was significantly negatively associated with mental health measures such as depression, trauma, and adverse childhood experiences and marijuana and stimulants use. Depression had the highest level of relative importance in its association with ART adherence. During in-depth interviews with 29 participants, barriers to and facilitators of accessing and maintaining mental health services were identified. Most participants favored technology use for mental health and substance use service delivery, including videoconferencing with a counselor. Provision of ongoing mental health and substance use treatment is an important mechanism to achieving HIV treatment engagement. Technology, particularly videoconferencing, may have the capacity to overcome many barriers to care by increasing accessibility of these services.

KEYWORDS:

• Technology
• mental health
• youth
• HIV
• telehealth

Acknowledgements

The authors thank the San Francisco Bay Area youth and young adults who participated in this study.

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

Research reported in this publication was supported by the California HIV/AIDS Research Program (CHRP) award numbers HD15-SF-060 (co-PIs Saberi and Dawson Rose) and the National Institutes of Health award numbers K23MH097649 (PI Saberi) and K24DA037034 (Johnson). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.