High prevalence of pain and mental health conditions amongst people well-established in HIV care: results of a cross-sectional survey in Lima, Peru

People living with HIV (PLWH) are at risk for mental health (MH) disorders and pain, but this burden is largely unknown in low/middle-income countries. From February-October 2023, we conducted a cross-sectional survey at a large HIV clinic in Lima, Peru to quantify the prevalence of MH disorders and pain amongst PLWH established in care and to explore relationships between MH and well-managed HIV. At clinic visits, PLWH were invited to complete validated measures for depression, post-traumatic stress disorder (PTSD), alcohol use disorder (AUD), and pain (PHQ-8, PCL5, AUDIT-C, and BPISF). We abstracted data on treatment and viral suppression from medical charts. We calculated the prevalence of depression (PHQ8 ≥ 10), PTSD (PCL-5 ≥ 30), AUD (AUDIT-C ≥ 4 for men, ≥ 3 for women), and pain severity/interference (none, mild, moderate, or severe). We conducted logistic regression analyses to determine associations between MH/pain and viral suppression. Among 397 participants, 32% (95% CI: 27-37%) reported AUD, 21% (17-26%) reported depression, and 13% (9.5-16%) reported PTSD; 14% (11-18%) and 12% (9.3-16%) reported moderate/severe pain intensity and interference, respectively. There were no associations between MH/pain and viral suppression. High levels of MH disorders and pain among PLWH established in care suggest screening is needed for all PLWH, even those with well-controlled HIV.