Investigating social and structural correlates of mental health symptoms, access to services, and implications for trauma-informed and community-engaged mental health programs

Evidence has suggested that there is a substantial gap to access mental health services in the Canadian health systems. Such a gap is more prominent among marginalized groups such as women living with HIV (WLWH), as they often experience high levels of trauma, violence and other social-structural barriers to access these services. The majority of research on mental health among women living with HIV (WLWH) has focused on symptoms of depression and their relationships with access to HIV treatment and care. Far less is known about how mental health symptoms change over time, the socio-ecological factors associated with these changes, and how community engagement promotes mental health. Overall, the study will draw on a quantative, intersectional approach to investigate correlates of mental health symptoms, access to services, and how these inform community-based mental health programs. Specifically, the study will look at changes in mental health symptoms among WLWH and factors related to these changes, including but not limited to race/ethnicity, sexual orientation, housing, discrimination, HIV stigma and use of mental health services. The study will estimate the potential effects of community engagement programs on mental health among this population. The study will also estimate the impact of COVID-19 on WLWH's access to mental health care and mental health symptoms, which tells us about mental health service interruption and mental health needs during a public health emergency for a population experiencing high levels of social and structural marginalization. The study will use data from the Sexual Health & HIV/AIDS: Longitudinal Women's Needs Assessment (SHAWNA) Project, a longitudinal, community-based study. The results will be used for evidence-based social interventions and policies to improve integrated mental health care for WLWH.