Little is known about the prevalence of post-traumatic stress disorder (PTSD) in emerging adults living with HIV in low-income countries.

Determine prevalence of trauma exposure, prevalence of probable PTSD and conditional prevalence of probable PTSD for different traumatic events; and better understand the experiences of individuals with HIV and PTSD.

This mixed method study used secondary data from a cross-sectional survey of people (N = 222) aged 18 to 29 living with HIV in Zimbabwe and primary qualitative data collection. The PTSD Checklist for DSM-5 (PCL-5) and the Life Events Checklist for DSM-5 (LEC-5) were used to measure PTSD and exposure to traumatic events, both translated to Shona. In-depth interviews (n = 8) with participants who met the criteria for probable PTSD were analysed using thematic analysis.

In all, 68.3% [95% CI (61.4–74.1)] of participants reported exposure to at least one traumatic event. The observed prevalence of probable PTSD was 8.6% [95% CI (5.2–13.0)], most observed following exposure to fire or explosion 29.0% [95% CI (13.0–45.0)] and sexual assault 27.8% [95% CI (7.2–48.7)]. Probable PTSD was also more prevalent following multiple exposure to trauma; four and six events, N = 4 (21%) [95% CI (5.1–8.8)] each, two and three events N = 3 (15.7%) [95% CI (5.9–9.2)] each, and five events N = 1 (5.4%) [95% CI (7.5–9.6)]. Qualitative results indicated that HIV stigma exacerbated psychological distress from trauma.

Despite trauma exposure being common, prevalence of probable PTSD was not high, but was higher in those with multiple exposures. Participants described coping strategies, including social support and religious thinking.

Mental disorders are common in people living with HIV (PLWH) but often remain untreated. This study aimed to explore the treatment gap for mental disorders in adults followed-up in antiretroviral therapy (ART) programmes in South Africa and disparities between ART programmes regarding the provision of mental health services.

We conducted a cohort study using ART programme data and linked pharmacy and hospitalisation data to examine the 12-month prevalence of treatment for mental disorders and factors associated with the rate of treatment for mental disorders among adults, aged 15–49 years, followed-up from 1 January 2012 to 31 December 2017 at one private care, one public tertiary care and two pubic primary care ART programmes in South Africa. We calculated the treatment gap for mental disorders as the discrepancy between the 12-month prevalence of mental disorders in PLWH (aged 15–49 years) in South Africa (estimated based on data from the Global Burden of Disease study) and the 12-month prevalence of treatment for mental disorders in ART programmes. We calculated adjusted rate ratios (aRRs) for factors associated with the treatment rate of mental disorders using Poisson regression.

In total, 182 285 ART patients were followed-up over 405 153 person-years. In 2017, the estimated treatment gap for mental disorders was 40.5% (95% confidence interval [CI] 19.5–52.9) for patients followed-up in private care, 96.5% (95% CI 95.0–97.5) for patients followed-up in public primary care and 65.0% (95% CI 36.5–85.1) for patients followed-up in public tertiary care ART programmes. Rates of treatment with antidepressants, anxiolytics and antipsychotics were 17 (aRR 0.06, 95% CI 0.06–0.07), 50 (aRR 0.02, 95% CI 0.01–0.03) and 2.6 (aRR 0.39, 95% CI 0.35–0.43) times lower in public primary care programmes than in the private sector programmes.

There is a large treatment gap for mental disorders in PLWH in South Africa and substantial disparities in access to mental health services between patients receiving ART in the public vs the private sector. In the public sector and especially in public primary care, PLWH with common mental disorders remain mostly untreated.

To elucidate the factors influencing food intake and preferences for potential nutritional supplements to treat mild and moderate malnutrition among adult people living with HIV (PLHIV).

Qualitative research using in-depth interviews with a triangulation of participants and an iterative approach to data collection.

The study was conducted in a health clinic of rural Chilomoni, a southern town of Blantyre district, Malawi.

Male and female participants, aged 18–49 years (n 24), affected by HIV; health surveillance assistants of Chilomoni clinic (n 8).

Six themes emerged from the in-depth interviews: (i) PLHIV perceived having a poor-quality diet; (ii) health challenges determine the preferences of PLHIV for food; (iii) liquid–thick, soft textures and subtle natural colours and flavours are preferred; (iv) preferred organoleptic characteristics of nutritional supplements resemble those of local foods; (v) food insecurity may contribute to intra-household sharing of nutritional supplements; and (vi) health surveillance assistants and family members influence PLHIV’s dietary behaviours. No differences by sex were found. The emergent themes were corroborated by health surveillance assistants through participant triangulation.

In this setting, a thickened liquid supplement, slightly sweet and sour, may be well accepted. A combination of quantitative and qualitative methods for data collection should follow to further develop the nutritional supplement and to fine tune the organoleptic characteristics of the product to the taste and requirements of PLHIV. Results of the present study provide a first approach to elucidate the factors influencing food intake and preferences for potential nutritional supplements among adult PLHIV.