Exploring Nurse’s Perceptions of Integration of Mental Health Services in HIV/AIDS Treatment in Lesotho: A Qualitative Survey

Abstract

Background: Mental disorders are highly prevalent among people living with HIV/AIDS compared with the general population. In sub-Saharan Africa, where Lesotho resides, there are high HIV/AIDS and mental disorder prevalence with significant treatment gaps. Nurses are the primary HIV/AIDS treatment providers in Lesotho but lack the skills and resources to implement mental health care integration, which the World Health Organisation recommends. This study sought to explore and describe the perceptions of nurses regarding the integration of mental health services in HIV/AIDS treatment. A qualitative, explorative, and descriptive research design was used to collect data from a sample of 10 nurses who were purposively selected. A total of six in-depth interviews and one focus group discussion were conducted. Permission to conduct the study was sought from the Ministry of Health (ID46-2022). Written informed consent was sought from the participants, who were allowed to ask questions and could withdraw from the study without any prejudice. Data were transcribed verbatim and analysed using thematic analysis. Some nurses described uncertainty about the relationship between mental health and HIV/AIDS, while others described antiretroviral treatment as a factor that influences a patient’s mental health. Intrinsic factors that influenced their ability to integrate the services were empathy and personal experiences. Extrinsic factors that influenced their ability were the high prevalence of mental health illness and the collaboration from village health workers. The lack of competency and other health service limitations hampered the integration of mental health services in HIV/AIDS management. These findings necessitate the need for training and continuing professional development for nurses in the provision of mental health services to PLWHIV. Nursing curricula need to work towards the integration of mental health into HIV/AIDS treatment programs.