A Task-Shifting Problem-Solving Therapy Intervention for Depression and Barriers to Antiretroviral Therapy Adherence for People Living With HIV in Zimbabwe: Case Series.

Journal: Cognitive and behavioral practice

Volume: 27

Issue: 1

Year of Publication: 

Affiliated Institutions:  College of Health Sciences, University of Zimbabwe, Harare, Zimbabwe. Department of Psychology, University of Maryland, MD, USA. Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK. Massachusetts General Hospital/Harvard Medical School, Boston, MA, USA. Health Service & Population Research Department, Centre for Public Mental Health, Institute of Psychiatry, Psychology & Neuroscience, King's College London, Box PO , De Crespigny Park, London SE AF, UK.

Abstract summary 

HIV is prevalent in Sub-Saharan Africa, and depression frequently co-occurs. Depression is one of the most important predictors of poor adherence to antiretroviral therapy (ART). Little has been done to develop integrated interventions that are feasible and appropriate for task-shifting to nonspecialists that seek to address both depression and barriers to ART adherence in Sub-Saharan Africa. This case series describes an integrated intervention for depression and ART adherence delivered by a lay adherence counselor and supervised by a local psychologist. The 6-session intervention was based on problem-solving therapy for depression and for barriers to adherence (PST-AD), with stepped care for those whose depression did not recover with PST-AD. Primary outcomes were acceptability and depression. Acceptability was measured by participant attendance to the 6 sessions. Three case studies illustrate the structured intervention, solutions identified to adherence barriers and to problems underlying low mood, and changes seen in the clients' psychological symptoms. Acceptability of the intervention was high and common mental disorder symptoms scores measured using the SRQ-8 decreased overall. An integrated intervention for depression and adherence to ART appeared feasible in this low-income setting. An RCT of the intervention versus an appropriate comparison condition is needed to evaluate clinical and cost-effectiveness.

Authors & Co-authors:  Nyamayaro Primrose P Bere Tarisai T Magidson Jessica F JF Simms Victoria V O'Cleirigh Conall C Chibanda Dixon D Abas Melanie M

Study Outcome 

Source Link: Visit source

Statistics
Citations :  Abas M, Bowers T, Manda E, Cooper S, Machando D, Verhey R, … Chibanda D (2016). ‘Opening up the mind’: problem-solving therapy delivered by female lay health workers to improve access to evidence-based care for depression and other common mental disorders through the Friendship Bench Project in Zimbabwe. International Journal of Mental Health Systems, 10(1), 1–8. doi:10.1186/s13033-016-0071-9
Authors :  7
Identifiers
Doi : 10.1016/j.cbpra.2018.10.003
SSN : 1077-7229
Study Population
Male,Female
Mesh Terms
Other Terms
HIV;adherence;depression;integrated intervention;task-shifting
Study Design
Case Study
Study Approach
Country of Study
Zimbabwe
Publication Country
United States