Abstract:
World Health Organization (WHO) guidelines call for antiretroviral therapy (ART) for all people living with HIV (PLWH)
regardless of CD4 cell count, a policy often referred to as ‘treat all’. This article seeks to: (1) provide an overview of
mental health research among PLWH in sub-Saharan Africa (SSA) and interventions or strategies to address comorbid
mental illness among those living with HIV; and (2) describe key mental health-related recommendations to inform the
successful implementation and scale up of ‘treat all’ policies in SSA. An initial set of mental health-related research
recommendations was developed by a working group comprising investigators affiliated with the International epidemiology
Databases to Evaluate AIDS (IeDEA) consortium. Recommendations were shared with those who attended the All-Africa
IeDEA Meeting in Kigali, Rwanda in November 2017 and refined following the meeting. Recommendations reflect a
need for epidemiological research to examine the prevalence, incidence, and impact of mental health multimorbidities
on HIV treatment outcomes, intervention research to examine the extent to which improving the mental health of people
living with HIV enhances HIV treatment outcomes, and implementation science research to evaluate promising models
of integrated mental health and HIV care. Key research recommendations can advance understanding and treatment of
mental illness among those living with HIV in sub-Saharan Africa and beyond.