Psychosocial screening of youth living with HIV in an integrated care setting before and after COVID-19.

Background: Mental health concerns among youth living with HIV are well documented. Given the interconnection between physical and mental health, behavioral health screening in medical settings is recommended to ensure patients are linked to mental health services. Unfortunately, COVID-19 disrupted medical and mental health services for people living with HIV, including youth. However, the extent of this disruption and its impact are not entirely known.

Objective: We aimed to explore the impact of COVID-19 on psychosocial screening practices and outcomes among youth living with HIV aged 12-25 in an integrated care setting in the southeastern United States.

Methods: Using existing program evaluation and continuous quality improvement data, we examined psychosocial screenings before and after the onset of COVID-19 (2019-2022).

Results: Findings revealed decreased psychosocial screening of eligible youth living with HIV between 2019 and 2021, but an increase in 2022. The percentage of positive depression and anxiety screeners decreased between 2019 and 2020, increased in 2021, and decreased again in 2022. However, positive post-traumatic stress screeners increased between 2019 and 2020, decreased in 2021, and increased again in 2022. Substance use screening indicated a steady increase in alcohol and tobacco use between 2019 and 2021. In 2022, alcohol continued to increase, but tobacco use decreased.

Conclusions: Findings underscore the critical need for robust, adaptable psychosocial screening practices in integrated care settings to address the evolving mental health and substance use needs of youth living with HIV, especially during and after major public health disruptions.