“They need people to actually show up in their lives:” deploying community health workers to improve mental health and substance use outcomes among PLWH

Mental health and substance use disorders are associated with lower adherence to anti-retroviral treatment, and viral suppression among people living with HIV (PLWH). The first objective of this study was to identify syndemic drivers of mental health problems, substance use and HIV engagement among PLWH. The second aim was to elucidate perspectives on using community health workers (CHWs) as an implementation strategy for increasing engagement in harm reduction services, mental health care and HIV treatment. Key informant interviews analyzed using rapid qualitative analysis identified key themes related to poor MH and substance use as barriers to engagement in HIV care, housing insecurity, the essential role of CHWs in delivering harm reduction services, and other barriers and facilitators. Interventions are needed to evaluate the potential effectiveness of deploying CHWs to enhance coordination of care, trust and the quality of services received by PLWH with mental health and substance use disorders.