Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 Aug 28:7:e23.
doi: 10.1017/gmh.2020.14. eCollection 2020.

Effectiveness of a peer-led adolescent mental health intervention on HIV virological suppression and mental health in Zimbabwe: protocol of a cluster-randomised trial

Silindweyinkosi Chinoda  1 , Abigail Mutsinze  2 , Victoria Simms  3 , Rhulani Beji-Chauke  1 , Ruth Verhey  1 , Joanna Robinson  4 , Taryn Barker  4 , Owen Mugurungi  5 , Tsitsi Apollo  5 , Epiphany Munetsi  1 , Dorcas Sithole  6 , Helen A Weiss  3 , Dixon Chibanda  1   7   8 , Nicola Willis  2
Affiliations

Effectiveness of a peer-led adolescent mental health intervention on HIV virological suppression and mental health in Zimbabwe: protocol of a cluster-randomised trial

Silindweyinkosi Chinoda et al. Glob Ment Health (Camb). .

Abstract

Background: Adolescents living with HIV (ALHIV) experience a high burden of mental health disorder which is a barrier to antiretroviral therapy adherence. In Zimbabwe, trained, mentored peer supporters living with HIV (Community Adolescent Treatment Supporters - CATS) have been found to improve adherence, viral suppression and psychosocial well-being among ALHIV. The Friendship Bench is the largest integrated mental health programme in Africa. We hypothesise that combining the CATS programme and Friendship Bench will improve mental health and virological suppression among ALHIV compared with the CATS programme alone.

Methods: We will conduct a cluster-randomised controlled trial in 60 clinics randomised 1:1 in five provinces. ALHIV attending the control arm clinics will receive standard CATS support and clinic support following the Ministry of Health guidelines. Those attending the intervention arm clinics will receive Friendship Bench problem-solving therapy, delivered by trained CATS. Participants with the signs of psychological distress will be referred to the clinic for further assessment and management. The primary outcome is HIV virological failure (≥1000 copies/ml) or death at 48 weeks. Secondary outcomes include the proportion of adolescents with common mental disorder symptoms (defined as Shona Symptom Questionnaire (SSQ-14) score ≥8), proportion with depression symptoms (defined as Patient Health Questionnaire (PHQ-9) score ≥11), symptom severity (mean SSQ-14 and PHQ-9 scores) and EQ-5D score for health-related quality of life.

Conclusions: This trial evaluates the effectiveness of peer-delivery of mental health care on mental health and HIV viral load among ALHIV. If effective this intervention has the potential to be scaled-up to improve these outcomes.Trial registration: PACTR201810756862405. 08 October 2018.

Keywords: Adolescents; HIV; mental health virological suppression; peer-led.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1.
Fig. 1.
Study design.
See this image and copyright information in PMC

References

    1. Abas M, Nyamayaro P, Bere T, Saruchera E, Mothobi N, Simms V, Mangezi W, Macpherson K, Croome N, Magidson J, Makadzange A, Safren S, Chibanda D and O'Cleirigh C (2018) Feasibility and acceptability of a task-shifted intervention to enhance adherence to HIV medication and improve depression in people living with HIV in Zimbabwe, a low income country in Sub-Saharan Africa. AIDS and Behavior 22, 86–101. - PMC - PubMed
    1. Betancourt TS, Ng LC, Kirk CM, Brennan RT, Beardslee WR, Stulac S, Mushashi C, Nduwimana E, Mukunzi S, Nyirandagijimana B, Kalisa G, Rwabukwisi CF and Sezibera V (2017) Family-based promotion of mental health in children affected by HIV: a pilot randomized controlled trial. Journal of Child Psychology and Psychiatry, and Allied Disciplines, 58, 922–930. - PMC - PubMed
    1. Chibanda D, Bowers T, Verhey R, Rusakaniko S, Abas M, Weiss HA and Araya R (2015) The Friendship Bench programme: a cluster randomised controlled trial of a brief psychological intervention for common mental disorders delivered by lay health workers in Zimbabwe. International Journal of Mental Health Systems 9, 21. - PMC - PubMed
    1. Chibanda D, Mesu P, Kajawu L, Cowan F, Araya R and Abas MA (2011) Problem-solving therapy for depression and common mental disorders in Zimbabwe: piloting a task-shifting primary mental health care intervention in a population with a high prevalence of people living with HIV. BMC Public Health 11, 828. - PMC - PubMed
    1. Chibanda D, Verhey R, Gibson LJ, Munetsi E, Machando D, Rusakaniko S, Munjoma R, Araya R, Weiss HA and Abas M (2016a) Validation of screening tools for depression and anxiety disorders in a primary care population with high HIV prevalence in Zimbabwe. Journal of Affective Disorders 198, 50–55. - PubMed

LinkOut - more resources