TECHNICAL AREA

HIV testing, care, and treatment

 

RESEARCH PARTNERS

University of North Carolina, Chapel Hill

Lighthouse Trust, Malawi

 

DURATION 2016–2018

 

LOCATION

Lilongwe, Malawi

 

CONTACT

Brian Pence, University of North Carolina, Chapel Hill

RESOURCES Impulsiveness, depression, sexual behavior, and sexually transmitted infections and HIV-related outcomes among out-of-school adolescent girls and young women in rural southern Malawi HIV testing and treatment among adults working in the fishing sector, agricultural estates, and as market vendors in rural southern Malawi The impact of an integrated depression and HIV treatment program on mental health and HIV care outcomes among people newly initiating antiretroviral therapy in Malawi   The role of depression screening and treatment in achieving the UNAIDS 90–90–90 goals in sub-Saharan Africa   Can depression treatment feasibly be integrated into high-volume, routine HIV care in Malawi?   Integrating depression management into HIV primary care in central Malawi: the implementation of a pilot capacity building program   Hope for the future: Addressing depression as part of ART services in Malawi   Can depression screening be integrated into busy HIV clinics in Malawi? Early results demonstrate its feasibility and acceptability   Evaluating a depression treatment program on HIV care and mental health outcomes in Malawi

Treating Depression to Improve HIV Care Outcomes in Malawi

©NChenga/Flickr

 

The issue
Depression is common among people living with HIV in sub-Saharan Africa and likely represents an important barrier to consistent HIV care engagement and long-term viral suppression. However, the potential for depression treatment to improve HIV care outcomes has received little attention in the region, in part because of the very limited mental health infrastructure in many countries.

 

Our approach
Project SOAR is implementing and evaluating the integration of a depression management model into HIV care in Malawi. The intervention combines two depression treatment models—algorithm-based medication management and problem-solving therapy—into a single intervention that is offered at two HIV clinics in Lilongwe to patients newly initiating antiretroviral treatment and who have depressive symptoms. The study employs a multiple baseline design to compare depression response, retention in HIV care, and viral suppression among patients receiving the combined intervention compared to usual care.

 

The impact
This study will provide critical evidence on the feasibility, effectiveness, and cost-effectiveness of an integrated depression treatment model for improving retention in and adherence to HIV care. Such evidence has implications not only for the applicability of the model in Malawi but for other countries in sub-Saharan Africa as well.