RT Journal Article SR Electronic T1 Roll-out of HIV pre-exposure prophylaxis: a gateway to mental health promotion JF BMJ Global Health JO BMJ Global Health FD BMJ Publishing Group Ltd SP e007212 DO 10.1136/bmjgh-2021-007212 VO 6 IS 12 A1 Daniel J Ikeda A1 Khameer Kidia A1 Bruce D Agins A1 Jessica E Haberer A1 Alexander C Tsai YR 2021 UL http://gh.bmj.com/content/6/12/e007212.abstract AB HIV remains a pressing global health problem, with 1.5 million new infections reported globally in 2020. HIV pre-exposure prophylaxis (PrEP) can lower the likelihood of HIV acquisition among populations at elevated risk, yet its global roll-out has been discouragingly slow. Psychosocial factors, such as co-occurring mental illness and substance use, are highly prevalent among populations likely to benefit from PrEP, and have been shown to undermine persistence and adherence. In this analysis, we review the high burden of mental health problems among PrEP candidates and contend that inattention to mental health stands to undermine efforts to implement PrEP on a global scale. We conclude that integration of mental health screening and treatment within PrEP scale-up efforts represents an important strategy for maximising PrEP effectiveness while addressing the high burden of mental illness among at-risk populations. As implementers seek to integrate mental health services within PrEP services, efforts to keep access to PrEP as low-threshold as possible should be maintained. Moreover, programmes should seek to implement mental health interventions that are sensitive to local resource constraints and seek to reduce intersecting stigmas associated with HIV and mental illness.Not applicable.