Systematic review reveals diverse models for integrating HIV and mental health care, indicating potential to improve service delivery despite a lack of evidence in low-resource settings.
Key Points
Synthesize existing literature on interventions, approaches, and organizational models designed to integrate HIV and mental health services.
Conducted a systematic search across multiple electronic databases from inception through October 2015 for studies evaluating HIV and mental health service integration.
Identified, screened, and extracted data from eligible papers, assessing evaluative studies for methodological risk of bias.
Identified 45 eligible articles describing three primary integration models: single-facility integration, multi-facility collaborative networks, and non-physician case-manager-coordinated care.
Single-facility models enhanced multidisciplinary coordination and reduced access barriers, multi-facility networks accommodated complex comorbidities but risked fragmented care, and case management promoted continuity but required extensive provider training.
Noted a lack of research from low- and middle-income countries, with most available studies relying on descriptive designs rather than rigorous evaluations of cost-effectiveness or long-term clinical outcomes.