Service capacity of institutions serving the mental health needs of persons living with HIV in Georgia.

This study mapped the availability, integration, and referral patterns of mental health (MH) and substance use disorder (SUD) services for people living with HIV (PLWH) in Georgia. PLWH face a heightened burden of MH conditions, compounded by systemic and social barriers. In Georgia, these challenges are exacerbated by fragmented healthcare system, centralized HIV care, and limited service integration. Cross-sectional survey was conducted between January-August 2024 using a structured questionnaire distributed to 80 institutions across 11 regions of Georgia, including MH centers, HIV-focused NGOs, PLWH treatment and support organizations, and primary healthcare (PHC) centers. Data analysis included descriptive statistics and social network-informed methods. Findings revealed geographic disparities, with services concentrated in urban centers, particularly Tbilisi. Specialized MH institutions provided most clinical MH and SUD services, while HIV-focused organizations delivered treatment and support services. However, formal service protocols for HIV-related MH care were rare. Referral pathways were siloed, showing strong internal linkages among HIV service providers but weak or absent connections with MH and PHC sectors. These findings highlight the urgent need to integrate MH services into HIV platforms and strengthen inter-organizational referrals ensuring comprehensive, person-centered care for PLWH.