Background: Psychiatric disorders and Human Immunodeficiency Virus (HIV) are significant global health conditions that often co-occur. Most people living with HIV, 65% of the global 40.8 million, are from the African region. Studies show a higher prevalence of psychiatric disorders among people living with HIV (PLHIV) than in the general population, with estimates ranging from 28% to 62%. PLHIV with comorbid psychiatric disorders experience a disproportionate burden of poor HIV outcomes. They struggle with linkage to care, reduced engagement, poor viral suppression rates, and increased risk of morbidity and mortality. Objectives: First, we aim to determine the viral suppression status of psychiatric inpatients with comorbid HIV at two hospitals in Kenya. Second, we aim to explore factors influencing engagement in care and possible intervention strategies for psychiatric inpatients with comorbid HIV at two hospitals in Kenya. Methods: For the first objective, we will conduct a cross-sectional study among all adult psychiatric inpatients at two hospitals in Kenya. One hospital will be a national tertiary hospital in an urban location, while the second hospital will be a sub-county hospital in a rural location. We will collect sociodemographic data and clinical data such as baseline CD4 count, baseline viral load, latest viral load, duration of HIV care, number of missed HIV clinics over the past 24 months, psychiatric diagnosis, and duration of psychiatric disorder. We will use STATA version 18 for quantitative analysis. For the second objective, we will conduct in-depth interviews among the psychiatric inpatients and healthcare providers in the psychiatric wards and the Comprehensive Care Centers at the two hospitals. The semi-structured guide for patients will explore their lived experiences regarding linkage to care, retention in care, previous post-discharge continuity of care (where applicable), challenges during care, and possible intervention strategies. The semi-structured guide for healthcare providers will explore providers’ roles, experience with different treatment guidelines, and World Health Organization resources, challenges, and possible intervention strategies. We will use NVivo for qualitative data analysis.

This study among psychiatric inpatients with comorbid HIV will provide insights into predictors of viral suppression and factors influencing engagement in care that will ultimately inform practice and policy in strengthening existing interventions or developing and implementing new interventions to improve health outcomes and align with the World Health Organization recommendations.