Burden of mental health symptoms and access to needed mental health care among people with HIV in New England.

People with HIV (PWH) are disproportionately impacted by mental health symptoms. HIV clinics strive to connect PWH with mental health services, but the effectiveness of these efforts is unknown. This project assessed the prevalence of mental health symptoms and barriers to related care among 133 PWH connected to two HIV clinics in New England. Participants were 49.8 years old on average, 38.3% White, 20.3% Hispanic/Latinx, and 67.7% male. Many participants reported moderate-to-severe symptoms of depression (49.6%), anxiety (33.1%), anger (22.6%), and sleep disturbance (34.6%). Compared with participants who were able to access needed mental health care, those who could not (21.8%) were younger, less likely to have HIV viral suppression, had higher rates of mental health symptoms, greater interpersonal and structural barriers to care, and were more likely to report that their HIV care provider offered to help them find mental health care. A logistic regression demonstrated that structural barriers alone were associated with PWH being unable to receive needed mental health care (OR 3.23, p < .001). Integrating connections to mental health services in HIV clinics could benefit the majority of PWH, but gaps remain in connecting PWH facing significant structural barriers.Abbreviations: ASSIST: alcohol, smoking, and substance involvement screening test; CI: confidence interval; CBT: cognitive behavioral therapy; MI: motivational interviewing; OR: odds ratio; P/B CFAR: Providence/Boston Center for AIDS Research; PROMIS: patient reported outcome measurement information system; PWH: people with HIV​.