Mental Health Care Is HIV Care
Dr. Ouk Vichea discusses how supporting researchers can lead to improved health—and mental health—for people living with HIV in Cambodia
Studies have shown that mental health disorders, such as depression and anxiety, are common among people living with HIV (PLWH) in the Asia-Pacific region, potentially leading to suboptimal antiretroviral therapy (ART) adherence, poorer quality of life, and greater disability.
Addressing mental health as part of HIV care not only improves psychological wellbeing but also helps PLWH stay in care and sustain viral load suppression, key to achieving better overall health outcomes.
CHIMERA—an HIV, mental health, and implementation science research training initiative conducted by amfAR’s TREAT Asia program and funded through the Fogarty International Center of the US National Institutes of Health—is helping clinicians and researchers in Cambodia, Malaysia, the Philippines, and Thailand stay current on the latest science on HIV and mental health with expert-led training courses and one-on-one mentoring.
“Training for early-stage investigators in Cambodia is very important for me and my colleagues as it allows us to learn and understand the association between HIV and mental health, and the negative impacts of mental health disorders on long-term care and treatment of people living with HIV,” shared Ouk Vichea, MD, MPH, about his experience as a CHIMERA Fellow.
Dr. Vichea serves as Director of the National Center for HIV/AIDS, Dermatology and STD Control (NCHADS) at the Cambodian Ministry of Health. He and two of his colleagues, Drs. Bora Ngauv and Somanythd Chhay Meng, have been participating in the program.
As part of CHIMERA, Fellows hone a wide range of skills, from designing implementation research, developing research protocols, and putting into practice research ethics, to writing abstracts and publishing scientific manuscripts.
“Building our capacity in implementation science research methods is very relevant and useful for us, so that we can conduct the research to improve our HIV prevention, care, and treatment program, as well as share Cambodia’s experiences and practices on prevention and care models with the world,” he added.
Cambodia has seen immense progress in reducing new HIV infections, but, Dr. Vichea noted, members of key populations and their partners, and young men between the ages of 15 and 25 continue to experience the highest risks of acquiring HIV.
Working in close collaboration with international and community-based development partners, NCHADS has implemented HIV self-testing, partner testing, community-based testing, peer-driven interventions, social media campaigns, and pre-exposure prophylaxis (PrEP), including a rollout of long-acting injectable cabotegravir for PrEP at three sites in Phnom Penh.
NCHADS has also “tracked progress along the treatment cascade to retain people living with HIV on treatment to achieve viral load suppression,” said Dr. Vichea. “As a result, Cambodia achieved 92%-100%-98% against the global targets of 95% of people living with HIV knowing their HIV status, 95% of them being on treatment, and 95% of those on treatment having viral suppression.”
Cambodia’s Ministry of Health is also working on the overlapping epidemics of HIV and TB, and the national programs for each of these conditions work closely together, noted Dr. Vichea. High on their list of priorities is working to improve HIV screening among TB patients and TB screening and preventive therapy among PLWH on ART, with research supported by amfAR’s TREAT Asia program through the IeDEA global consortium and the Institut Pasteur du Cambodge, among other partners.
About CHIMERA, Dr. Vichea said, “Being part of this training course has been a motivational factor to drive me and my team to advocate with development partners, decision-makers, especially with the Director of the Department of Mental Health of the Ministry of Health, to explore strategies to make mental health services available and accessible to people living with HIV at our antiretroviral treatment clinics.
“For the future, I strongly hope that my team will be able to develop and conduct clinical research to address priority topics and improve the HIV prevention, care, and treatment program in Cambodia.”
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