Haas, Andreas D.Lienhard, RaphaelDidden, ChristianeCornell, MornaFolb, NaomiBoshomane, Tebatso M.G.Salazar‑Vizcaya, LuisRufeux, YannNyakato, PatienceWettstein, Anja E.Tlali, MphoDavies, Mary‑AnnVon Groote, PerWainberg, MiltonEgger, MatthiasMaartens, GaryJoaska, John A.2023-09-222023-09-222023-06Haas, A.D., Lienhard, R., Didden, C. et al. Mental Health, ART Adherence, and Viral Suppression Among Adolescents and Adults Living with HIV in South Africa: A Cohort Study. AIDS and Behavior 27, 1849–1861 (2023). https://doi.org/10.1007/s10461-022-03916-x.1090-7165 (print)1573-3254 (online)10.1007/s10461-022-03916-xhttp://hdl.handle.net/2263/92391DATA 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. org/contact-us/.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.en© The Author(s) 2022. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License.Mental disordersAdherenceViral suppressionHuman immunodeficiency virus (HIV)Antiretroviral therapy (ART)South Africa (SA)SDG-03: Good health and well-beingPeople living with HIV (PLHIV)Article