WHO Issues New HIV Guidelines Integrating Chronic and Mental Health Care

The World Health Organization (WHO) has released a new guideline designed to strengthen HIV service delivery worldwide by integrating care for other chronic health conditions and ensuring better long-term adherence to antiretroviral therapy (ART). The recommendations reflect updated scientific evidence and highlight the importance of person-centred, holistic care for the millions of people living with HIV globally.

A Shift Toward Integrated HIV Services

The updated guideline underscores WHO’s call for integrated health services, moving beyond HIV treatment alone to address broader physical and mental health needs. This approach aims to improve the overall quality of life, longevity, and well-being of people living with HIV.

“By integrating hypertension, diabetes and mental health care into HIV services, and ensuring timely, tailored support for adherence, we can help people stay on treatment and improve well-being,” said Dr. Tereza Kasaeva, Director of WHO’s Department for HIV, Tuberculosis, Hepatitis and Sexually Transmitted Infections.

Three Key Updates

1. Integration of Hypertension and Diabetes Care WHO now strongly recommends incorporating non-communicable disease (NCD) management—particularly diabetes and hypertension—into HIV services. Data suggest that in sub-Saharan Africa, up to 5% of people living with HIV also have diabetes, while 25% live with hypertension. These figures are comparable to those reported in other parts of the world. Left untreated, these conditions increase the risk of cardiovascular disease and other complications, potentially undermining HIV treatment outcomes.

2. Integration of Mental Health Care The guideline places a new emphasis on addressing depression, anxiety, and alcohol use disorders within HIV services. Mental health conditions are widespread among people living with HIV, with up to one-third reporting symptoms of depression or anxiety. Additionally, at least 20% live with alcohol use disorder, which is linked to poor medication adherence, unsafe sexual behaviours, and worsened overall health. By integrating screening and treatment for mental health conditions, HIV programmes can better support adherence and improve health outcomes.

3. Updated Adherence Support Interventions WHO has updated its evidence-based recommendations for supporting ART adherence, crucial for achieving viral suppression and preventing transmission. These include:

   • Regular counselling tailored to individual needs

   • Use of reminders (digital and manual)

   • Peer support networks and lay health workers

   • Education initiatives that help patients understand the benefits of lifelong treatment

   Such interventions are proven to improve adherence rates, sustain viral load suppression, and enhance the well-being of individuals.

Addressing a Changing Epidemic

The new guideline reflects the evolving needs of people living with HIV. While ART has transformed HIV into a manageable chronic condition, individuals are increasingly facing co-morbidities linked to ageing, lifestyle, and social determinants of health. Integrated services will reduce the fragmentation of care, cut down on clinic visits, and improve health outcomes by treating the person as a whole rather than focusing narrowly on HIV.

Broader Impact and Future Directions

The integration of HIV services with NCD and mental health care aligns with global health priorities, including the UN Sustainable Development Goals (SDGs) on health and well-being. By strengthening health systems, WHO’s guideline supports a dual goal: improving the lives of people with HIV while reducing the strain on overburdened health facilities.

The update also highlights the importance of community engagement, ensuring that peer support, lay counsellors, and community health workers are part of the system delivering adherence support and health education.

Toward Person-Centred HIV Care

WHO’s recommendations reinforce a holistic model of HIV care—one that integrates treatment, prevention, and support across physical and mental health domains. By doing so, the organization hopes to ensure that people living with HIV not only survive but thrive, leading healthier and longer lives.