Association between mental health and substance use among reproductive-age women with HIV on cervical cancer screening and viral suppression outcomes.

Women with HIV (WWH) face a heightened risk of cervical cancer and sub-optimal viral suppression. Although mental health conditions and substance use are known barriers to cervical cancer screening and viral suppression among WWH, little is known about the impact of specific mental health symptoms and substance use issues in reproductive-age WWH. This cross-sectional study examined the associations among depression and anxiety symptoms, substance use, cervical cancer screening, and viral suppression in a cohort of reproductive-age WWH enrolled in the Florida Cohort Study. Of WWH (n = 202) in the study, 42% reported anxiety, 35% reported depressive symptoms, 49% reported drug use, and 64% reported alcohol use within the past 12 months. In addition, 24% were not virally suppressed, 34% did not receive cervical cancer screening within the last year, and 13% did not receive cervical cancer screening within the last 3 years. Sub-optimal cervical cancer screening within the last year was associated with depression (p = 0.04) and anxiety (p = 0.007) symptoms. Mental health symptoms were significantly related to sub-optimal cervical cancer screening, which may be a target for clinical intervention. Future research should include social and structural barriers that may exist for achieving guideline-concordant cervical cancer screening and viral suppression.