Hospitals integrate Mental Health into HIV/AIDS Care

Due to the torture she endured from her husband, a 22-year-old woman stopped visiting a health facility to collect her antiretroviral (ARVs) drugs. This significantly impacted her life as she was not adhering to her medication.

She remembers that all of this happened because her husband had married another woman, which led to him restricting her movements and ceasing his support.

"My husband would lock me outside when he found out I was at a neighbour's place, causing me to miss taking my ARVs," she says.

The torture, isolation and lack of sufficient food resulted in her developing depression. The young woman, residing in the Maaji Refugee Settlement in Adjumani district, used to receive her medication at Ayiri Health Centre III. Fortunately, the health facility introduced her to a support group consisting of 10 women facing similar challenges.

Upon joining the group therapy sessions, she had the opportunity to hear other women's stories and share her own experience of the torture she endured. The group therapist provided valuable advice on how to lead a happier life, ultimately helping her overcome depression.

George Candia a nurse in the ART/Tuberculosis clinic at Ayiri Health Center III, says they had formed two groups, with a focus on females who often experience more psychosocial challenges and stigma-related stress.

‘’Since the formation of these groups, each consisting of 10 women, they have been able to relate to one another, share experiences, build self-confidence and accept their conditions better, resulting in improved adherence to treatment,’’ Candia said during a meeting on Tuesday.

These talk therapy sessions were introduced at the facility and in Adjumani district by Strongmind Uganda (SMU) in collaboration with other partners.

Candia shared that all women in the group have successfully suppressed their viral loads. He stressed that depression is common among People Living with HIV/AIDS due to the nature of the disease, but its severity depends on how well they accept their condition and their surrounding circumstances.

He highlighted that successful talk therapy sessions have empowered these women to explore their potential, and many of them are now eager to engage in income-generating activities. Even after completing their talk therapy sessions, they are committed to continuing with activities such as making liquid soaps.

At the hospital's ART clinic, they currently serve at least 120 active HIV clients.

Burden of mental health

In Uganda, the recent statistics from the health ministry and the Uganda Counselling Association revealed that an estimated 14 million Ugandans suffer from a form of mental disorder. This meant that every 35 out of 100 Ugandans may be battling a mental health problem.

Early this year, Butabika National Mental hospital executive director Dr Juliet Nakku said the hospital was overwhelmed by the increasing number of patients with mental illness, asking the Government for more funding.

Nakku said they admit 20-50 patients daily, while the outpatient department attends to about 300 patients. She said the bulk of patients suffer from mental health as a result of depression, alcohol and other substance abuse, severe mental disorders, bipolar disorders, and psychosis.

Health ministry principal medical officer and acting assistant commissioner mental health and control of substance abuse Dr Hafsa Lukwata confirmed that health facilities are integrating mental health into HIV and AIDS care.

She noted that there is a need to provide more training and support to health workers to better assess and assist individuals with mental health issues. They have also trained Village Health Teams to identify and support clients in their communities, ensuring medication adherence and referring cases to health facilities.

HIV burden

Globally, Uganda is ranked 5th among those with the highest HIV burden. The worrying bit is that women are more affected than men. For instance, data for 2022 indicates that Uganda’s HIV prevalence stands at 5.1%. HIV prevalence in women stands at 6.5% and for men at 3.9%.

Of the 52,000 new HIV infections in Uganda recorded last year, women accounted for 30,000, and 70% of those were adolescent girls and young women aged between 15 and 25.