Mental Health Integration in HIV Care Programs at Secondary Health Facilities in Benue State, North Central Nigeria

Mental disorders are highly prevalent among people living with HIV and have a significant negative impact on treatment engagement and viral suppression, yet mental health integration within HIV care programs remains inadequate in many Nigerian secondary health facilities. This study evaluates the extent and quality of mental health integration in HIV care programs at secondary health facilities in Benue State, North Central Nigeria. A health systems assessment design will be used, with structured facility surveys conducted at 20 secondary hospitals offering HIV services across five local government areas. Facility readiness for mental health integration will be assessed using the WHO Mental Health Integration Scorecard. In-depth interviews with 15 HIV program managers and clinical staff will explore barriers and facilitators of integration. The HIV Dementia Scale and PHQ-9 will be administered to 100 HIV-positive patients to assess current psychiatric screening coverage. Descriptive analysis will summarize facility readiness scores, and thematic analysis will address qualitative findings. Benue State, Nigeria's HIV epicenter in the Middle Belt, presents a critical context for this inquiry. Findings will guide program reform and inform national HIV treatment guidelines. Keywords: mental health integration, HIV care, Benue State, secondary health facilities, psychiatric screening