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Effect of a Psychological Intervention on Antiretroviral Therapy and Mental Health Outcomes in HIV-positive Adults in Zimbabwe

Not Applicable
Completed
Conditions
Mental Disorder
HIV Infections
Interventions
Behavioral: Friendship bench intervention
Other: Enhanced Standard of Care
Registration Number
NCT03704805
Lead Sponsor
University of Bern
Brief Summary

The aim of the study is to examine the effect of a psychological intervention on antiretroviral therapy outcomes and symptoms of common mental health disorders among adults living with HIV and common mental disorders in rural Zimbabwe.

Detailed Description

Common mental disorders are highly prevalent among people living with HIV. Left untreated, common mental disorders cause substantial disability and undermine individuals' ability to adhere to antiretroviral therapy, leading to poor antiretroviral therapy outcomes.

A recent cluster-randomized controlled trial from Harare, Zimbabwe showed that the friendship bench intervention (i.e. six sessions of problem-solving therapy delivered by lay health workers followed by a peer support group) effectively reduced symptoms of common mental disorders, but the effect of the intervention on antiretroviral therapy outcomes and its effectiveness in the rural setting has not been studied.

To examine the effect of the friendship bench intervention on antiretroviral therapy outcomes and symptoms of common mental disorders among adults living with HIV and common mental disorders in rural Zimbabwe, a cluster-randomized trial is conducted.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
480
Inclusion Criteria
  • Age ≥18 years
  • Use of first-line antiretroviral therapy for at least 6 months
  • Resident in Bikita District
  • Knowledge of English or Shona language
  • Ability to comprehend the information on the study
  • Positive screening for common mental disorders (SSQ-14 score ≥9)
  • Providing informed consent
Exclusion Criteria
  • Current psychosis / cognitive impairment
  • Clinical AIDS (WHO clinical stage 4)
  • Known pregnancy or ≤3 months postpartum

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Problem-Solving TherapyFriendship bench interventionParticipants in the intervention group receive the friendship bench intervention in addition to all services provided according to enhanced standard of care.
Enhanced Standard of CareEnhanced Standard of CareParticipants in the control group receive enhanced standard of care.
Problem-Solving TherapyEnhanced Standard of CareParticipants in the intervention group receive the friendship bench intervention in addition to all services provided according to enhanced standard of care.
Primary Outcome Measures
NameTimeMethod
Average difference in mean antiretroviral therapy adherence between 2 and 6 months2-6 months

Adherence will be calculated as percentage of prescribed doses taken and measured with the Medication Event Monitoring System (MEMS)

Secondary Outcome Measures
NameTimeMethod
Difference in mean antiretroviral therapy adherence between 1 and 12 months1-12 months

Adherence will be calculated as percentage of prescribed doses taken and measured with the Medication Event Monitoring System (MEMS)

Difference in change from baseline in Shona Symptoms Questionnaire (SSQ-14) scoreAt month 3, 6, 9, and 12

The Shone Symptoms Questionnaire is a 14 item tool. The reported total score is between 0 and 14. 14 is the highest level of mental disorder. Each item adds a score of 0 or 1 to the total score.

Difference in change from baseline in Patient Health Questionnaire (PHQ-9) scoreAt month 3, 6, 9, and 12

The Patient Health Questionnaire is a 9 item tool. The reported total score is between 0 and 27. 27 is the highest level of depression. Each item adds a score of 0 to 3 to the total score.

Viral load suppression (<1000 copies per milliliter)At month 6 (i.e., day 180 ± 90 days) and month 12 (i.e., day 360 ± 90 days)

Categorical (yes, no, invalid or missing).

Trial Locations

Locations (1)

Solidarmed

🇿🇼

Masvingo, Zimbabwe

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