" … They cannot help you because you're at McDonald's and you're asking for pizza". A qualitative exploration of the acceptability and appropriateness of integrating of pharmacotherapy for mental health treatment in HIV care among patients living with HIV and co-morbid mental health and substance use disorders.

Mental health disorders contribute to a lack of HIV care retention and adherence. Pharmacotherapy for mental health treatment may increase retention and adherence. However, there is often a lack of pharmacotherapy services for mental health treatment available in HIV care. The current study explores the extent to which people living with HIV find the integration of pharmacotherapy for mental health treatment into HIV care acceptable and appropriate. We conducted in-depth interviews with ten patients living with HIV and comorbid mental health or substance use challenges. We used rapid qualitative analysis to analyze the transcript data. Patients cited several barriers to mental health treatment, including having to coordinate and establish rapport with other providers. Participants' perspectives about whether HIV care providers should provide pharmacotherapy for mental health treatment varied. However, most respondents agreed that it would be beneficial for HIV care providers to maintain existing regimens or address lapses in mental health care. Patients also cited benefits to integration, including the ability to receive care from a trusted provider and increased access. These findings add to previous literature and demonstrate the nuanced nature of the acceptability of receiving pharmacotherapy for mental health treatment from an HIV care provider.