Identifying barriers and facilitators to psychosocial care for people living with HIV in Ireland: a mixed methods study

BackgroundThe effectiveness of antiretroviral therapy means that human immunodeficiency virus (HIV) can now be defined as a manageable chronic illness. It is the facilitation of psychosocial care that has increasingly become a priority, as people living with HIV (PLWH) are disproportionately impacted by psychosocial stressors compared to the general population. The aim of this study was to identify barriers and facilitators to psychosocial care for PLWH in Ireland.MethodsA mixed methods study design was used, employing a national survey of PLWH (n = 54) via Qualtrics and semi-structured interviews with healthcare professionals that provide clinical support to PLWH across Ireland (n = 11). Content analysis was used to analyse the interviews.ResultsMore than half (59.3%) of survey respondents agreed that living with HIV currently impacts their mental health, with nearly two thirds (64.8%) agreeing that they have experienced stigma as a result of living with HIV. Less than half (40.7%) were comfortable disclosing their status to family, and less than a third (27.8%) to friends. Stigma was identified by healthcare professionals as a barrier to psychosocial care, along with a number of system-level barriers, provider-level or practical barriers, and individual barriers. The value of multidisciplinary care teams and reliance on community support was emphasised, and potential for further integration of support services was highlighted.ConclusionCommunity-based organisations contribute significantly to the facilitation of psychosocial support for PLWH in Ireland, and greater integration of community services could promote a more holistic, patient-centred approach to meeting the diverse needs of this growing cohort. PLWH benefit from multidisciplinary care teams, and the facilitation of safe and effective peer support should be encouraged to afford opportunities to disclose and receive social support. HIV-related stigma remains a barrier to psychosocial care, highlighting the need for stigma reduction interventions.