Mental health burden among impoverished HIV-positive patients in Peru

Sonya Shin, Maribel Muñoz, Adolfo Caldas, Ying Wu, Jhon Zeladita, Milagros Wong, Betty Espiritu, Eduardo Sanchez, Miriam Callacna, Christian Rojas, Jorge Arevalo, Jose Luis Sebastian, Jaime Bayona

Research output: Contribution to journalArticlepeer-review

5 Scopus citations


HIV and poor mental health are intricately related. In settings of poverty, both are often rooted in structural factors related to material and social deprivation. We performed a qualitative analysis to understand factors contributing to poor emotional health and its impact among impoverished Peruvian HIV-infected individuals. We conducted focus group discussions with patients and providers consisting of semistructured, open-ended questions. Qualitative analysis provided insight into the profound impact of depression, isolation, stigma, and lack of social support among these patients. Living with HIV contributed significantly to mental health problems experienced by HIV-positive individuals; furthermore, long-standing stressors-such as economic hardship, fragmented family relationships, and substance use-shaped patients' outlooks, and may have contributed not only to current emotional hardship but to risk factors for contracting HIV as well. Once diagnosed with HIV/AIDS, many patients experienced hopelessness, stigma, and socioeconomic marginalization. Patients tended to rely on informal sources of support, including peers and community health workers, and rarely used formal mental health services. In resource-poor settings, the context of mental health problems among HIV-positive individuals must be framed within the larger structural context of poverty and social exclusion. Optimal strategies to address the mental health problems of these individuals should include integrating mental health services into HIV care, task shifting to utilize community health workers where human resources are scarce, and interventions aimed at poverty alleviation.

Original languageEnglish
Pages (from-to)18-25
Number of pages8
JournalJournal of the International Association of Physicians in AIDS Care
Issue number1
StatePublished - Jan 2011
Externally publishedYes


  • HIV
  • community health workers
  • depression
  • mental health
  • poverty
  • resource-poor setting


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