Perceived need, barriers to and facilitators of mental health care among HIV-infected PWID in Hanoi, Vietnam: a qualitative study

Harm Reduct J. 2019 Dec 26;16(1):74. doi: 10.1186/s12954-019-0349-8.

Abstract

Background: The HIV epidemic in Vietnam has been primarily driven by injection drug use. HIV-infected people who inject drugs (PWID) in Vietnam have very high rates of mental health problems, which can accelerate progression to AIDS and increase mortality rates. No research has explored the barriers and facilitators of mental health care for HIV-infected PWID in Vietnam.

Methods: We conducted 28 in-depth interviews among HIV-infected PWID (n = 16), HIV and MMT (methadone maintenance treatment) providers (n = 8), and health officials (n = 4) in Hanoi. We explored participants' perceptions of mental health disorders, and barriers and facilitators to seeking and receiving mental health care.

Results: HIV-infected PWID were perceived by both PWID, HIV/MMT providers, and health officials to be vulnerable to mental health problems and to have great need for mental health care. Perceived social, physical, and economical barriers included stigma towards HIV, injection drug use, and mental illnesses; lack of awareness around mental health issues; lack of human resources, facilities and information on mental health services; and limited affordability of mental health services. Social support from family and healthcare providers was a perceived facilitator of mental health care.

Conclusions: Interventions should raise self-awareness of HIV-infected PWID about common mental health problems; address social, physical, economic barriers to seeking mental health services; and increase social support for patients.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Attitude to Health
  • Denial, Psychological
  • Depressive Disorder / economics
  • Depressive Disorder / psychology
  • Depressive Disorder / rehabilitation
  • Facilities and Services Utilization
  • Female
  • HIV Infections / economics
  • HIV Infections / psychology
  • HIV Infections / therapy*
  • Health Expenditures
  • Health Services Accessibility / economics
  • Health Services Accessibility / statistics & numerical data
  • Health Workforce / statistics & numerical data
  • Humans
  • Male
  • Mental Disorders / economics
  • Mental Disorders / psychology
  • Mental Disorders / rehabilitation
  • Mental Health Services / economics
  • Mental Health Services / statistics & numerical data*
  • Middle Aged
  • Needs Assessment
  • Patient Acceptance of Health Care / psychology
  • Patient Education as Topic
  • Perception
  • Qualitative Research
  • Social Support
  • Substance Abuse, Intravenous / economics
  • Substance Abuse, Intravenous / psychology
  • Substance Abuse, Intravenous / rehabilitation*
  • Vietnam
  • Young Adult