Mental Health, ART Adherence, and Viral Suppression Among Adolescents and Adults Living with HIV in South Africa: A Cohort Study.

Haas, Andreas D; Lienhard, Raphael; Didden, Christiane; Cornell, Morna; Folb, Naomi; Boshomane, Tebatso M G; Salazar-Vizcaya, Luisa; Ruffieux, Yann; Nyakato, Patience; Wettstein, Anja E; Tlali, Mpho; Davies, Mary-Ann; von Groote, Per; Wainberg, Milton; Egger, Matthias; Maartens, Gary; Joska, John A (2023). Mental Health, ART Adherence, and Viral Suppression Among Adolescents and Adults Living with HIV in South Africa: A Cohort Study. AIDS and behavior, 27(6), pp. 1849-1861. Springer 10.1007/s10461-022-03916-x

Haas_AIDSBehav_2023.pdf - Published Version
Available under License Creative Commons: Attribution (CC-BY).

Download (895kB) | Preview

We followed adolescents and adults living with HIV aged older than 15 years who enrolled in a South African private-sector HIV programme to examine adherence and viral non-suppression (viral load > 400 copies/mL) of participants with (20,743, 38%) and without (33,635, 62%) mental health diagnoses. Mental health diagnoses were associated with unfavourable adherence patterns. The risk of viral non-suppression was higher among patients with organic mental disorders [adjusted risk ratio (aRR) 1.55, 95% confidence interval (CI) 1.22-1.96], substance use disorders (aRR 1.53, 95% CI 1.19-1.97), serious mental disorders (aRR 1.30, 95% CI 1.09-1.54), and depression (aRR 1.19, 95% CI 1.10-1.28) when compared with patients without mental health diagnoses. The risk of viral non-suppression was also higher among males, adolescents (15-19 years), and young adults (20-24 years). Our study highlights the need for psychosocial interventions to improve HIV treatment outcomes-particularly of adolescents and young adults-and supports strengthening mental health services in HIV treatment programmes.

Item Type:

Journal Article (Original Article)


04 Faculty of Medicine > Pre-clinic Human Medicine > Institute of Social and Preventive Medicine (ISPM)
04 Faculty of Medicine > Department of Haematology, Oncology, Infectious Diseases, Laboratory Medicine and Hospital Pharmacy (DOLS) > Clinic of Infectiology

Graduate School:

Graduate School for Health Sciences (GHS)

UniBE Contributor:

Haas, Andreas, Lienhard, Raphael Andreas, Didden, Christiane Helene, Salazar Vizcaya, Luisa Paola, Ruffieux, Yann, Wettstein, Anja Elisabeth, von Groote, Per Maximilian, Egger, Matthias


600 Technology > 610 Medicine & health
300 Social sciences, sociology & anthropology > 360 Social problems & social services






[4] Swiss National Science Foundation




Pubmed Import

Date Deposited:

09 Jan 2023 12:17

Last Modified:

02 May 2023 16:10

Publisher DOI:


PubMed ID:


Additional Information:

Open Access funding provided by University of Bern.

Uncontrolled Keywords:

Adherence Antiretroviral therapy HIV Mental disorders South Africa Viral suppression




Actions (login required)

Edit item Edit item
Provide Feedback