We followed adolescents and adults living with HIV aged older than 15 years who enrolled in a South African private-sector
HIV programme to examine adherence and viral non-suppression (viral load>400 copies/mL) of participants with (20,743,
38%) and without (33,635, 62%) mental health diagnoses. Mental health diagnoses were associated with unfavourable
adherence patterns. The risk of viral non-suppression was higher among patients with organic mental disorders [adjusted
risk ratio (aRR) 1.55, 95% confdence interval (CI) 1.22–1.96], substance use disorders (aRR 1.53, 95% CI 1.19–1.97),
serious mental disorders (aRR 1.30, 95% CI 1.09–1.54), and depression (aRR 1.19, 95% CI 1.10–1.28) when compared
with patients without mental health diagnoses. The risk of viral non-suppression was also higher among males, adolescents
(15–19 years), and young adults (20–24 years). Our study highlights the need for psychosocial interventions to improve HIV
treatment outcomes—particularly of adolescents and young adults—and supports strengthening mental health services in
HIV treatment programmes.
DATA AVAILABILITY: Data were obtained from the International epidemiology Databases to Evaluate AIDS–Southern Africa (IeDEA-SA). Data
cannot be made available online because of legal and ethical restrictions. To request data, readers may contact IeDEA-SA for consideration by filling out the online form available at https://www.iedea-sa.