Overview of Portfolio

Mental health challenges among people living with HIV (PLHIV) remain a critical but under-addressed issue, despite significant biomedical advances in HIV care. Persistent stigma and systemic barriers continue to impact psychological well-being, potentially undermining UK’s efforts to end HIV transmission by 2030. This thesis portfolio explores the psychological impact of living with HIV and examines a potential framework for improving mental health support.

Part A presents a qualitative study investigating the lived experiences of 16 adults living with HIV, most of whom reside in the rural UK. Using reflexive thematic analysis, the study identified how stigma, intersecting identities, and structural inequities interconnect to create profound psychological burdens and restrict access to appropriate mental health care. Key themes included the pervasive presence of stigma, challenges of navigating intersecting marginalised identities, and widespread barriers to culturally competent and accessible support.

Part B presents a theoretical review exploring how Compassion Focused Therapy (CFT) can inform and enhance psychological care for PLHIV. It argues that CFT’s emphasis on addressing shame, internalised stigma, and self-criticism provides a valuable framework for supporting emotional well-being for PLHIV. The review evaluates existing literature on CFT in this context and proposes its integration into HIV care as part of a holistic, person-centred approach.

Together, the two articles highlight the urgent need to reconceptualise mental health support as a fundamental pillar of HIV care, not a peripheral concern, in order to uphold public health goals and ensure the dignity and resilience of all people living with HIV.