Mental health interventions for persons living with HIV in low- and middle-income countries: a systematic review.

Journal: Journal of the International AIDS Society

Volume: 24 Suppl 2

Issue: Suppl 2

Year of Publication: 2021

Affiliated Institutions:  Department of Psychiatry, College of Health Sciences, Makerere University, Kampala, Uganda. Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA. Duke University Medical Center Library, Duke University Medical Center, Durham, NC, USA. The Butabika National Referral Hospital, Ministry of Health, Kampala, Uganda. The Joint United Nations Programme on HIV/AIDS, Geneva, Switzerland. Department of International Health, Bloomberg's School of Public Health, Johns Hopkins University, Baltimore, MD, USA. Department of Clinical Epidemiology & Biostatistics, McMaster University, Hamilton, ON, Canada. Zimbabwe AIDS Prevention Project, Department of Community Medicine, University of Zimbabwe, Harare, Zimbabwe. Reference Center for Alcohol, Tobacco and Other Drugs (CRATOD), São Paulo State Secretary of Health, São Paulo, Brazil. National Addiction Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK. HIV Mental Health Research Unit, Department of Psychiatry, Neuroscience Institute, University of Cape Town, Cape Town, South Africa.

Abstract summary 

Addressing the intersection between mental health and HIV is critical for the wellbeing of persons living with HIV (PLWH). This systematic review synthesized the literature on mental health interventions for PLWH in low- and middle-income countries (LMICs) to determine intervention components and explore their relationship with intervention effectiveness.We included only controlled clinical trials of interventions aiming to improve the mental health of PLWH. We conducted a search in the following databases: PubMed, CINAHL, PsycINFO and EMBASE for eligible studies describing the evaluation of interventions for mental health problems among PLWH in LMICs published through August 2020. Two reviewers independently screened references in two successive stages of title/abstract screening and then full-text screening for references meeting title/abstract criteria.We identified a total of 30 eligible articles representing 6477 PLWH who were assigned to either the intervention arm (n = 3182) or control arm (n = 3346). The mental health interventions evaluated were psychological (n = 17, 56.67%), pharmacological (n = 6, 20.00%), combined psychological and pharmacological (n = 1, 3.33%) and complementary/alternative treatments (n = 6, 20.00%). The mental health problems targeted were depression (n = 22, 73.33 %), multiple psychological symptoms (n = 1, 3.33%), alcohol and substance use problems (n = 4, 13.33%), post-traumatic stress disorder (n = 1, 3.33%) and HIV-related neuro-cognitive impairment (n = 2, 6.67%). Studies of interventions with significant effects had significantly a higher number of active ingredients than those without significant effects [3.41 (2.24) vs. 1.84 (1.46) Mean (SD)] [Mean difference = -1.56, 95% CI = -3.03 to -0.09, p = 0.037].There continue to be advances in mental health interventions for PLWH with mental illness in LMICs. However, more research is needed to elucidate how intervention components lead to intervention effectiveness. We recommend scale up of culturally appropriate interventions that have been successfully evaluated in low- and middle-income countries.

Authors & Co-authors:  Nakimuli-Mpungu Etheldreda E Musisi Seggane S Smith Colin M CM Von Isenburg Megan M Akimana Benedict B Shakarishvili Ani A Nachega Jean B JB Mills Edward J EJ Chibanda Dixon D Ribeiro Marcelo M V Williams Anna A Joska John A JA

Study Outcome 

Source Link: Visit source

Statistics
Citations :  Brown GR, Rundell JR, McManis SE, Kendall SN, Zachary R, Temoshok L. Prevalence of psychiatric disorders in early stages of HIV infection. Psychosomat Med. 1992;54(5):588–601.
Authors :  12
Identifiers
Doi : e25722
SSN : 1758-2652
Study Population
Male,Female
Mesh Terms
Developing Countries
Other Terms
HIV/AIDS;anti-retroviral therapy theory of change;low- and middle-income countries;mental health;psychotherapy;psychotropic
Study Design
Case Control Trial,Cross Sectional Study
Study Approach
Systemic Review
Country of Study
Publication Country
Switzerland