A Task-Shifting Problem-Solving Therapy Intervention for Depression and Barriers to Antiretroviral Therapy Adherence for People Living With HIV in Zimbabwe: Case Series.
HIV
adherence
depression
integrated intervention
task-shifting
Journal
Cognitive and behavioral practice
ISSN: 1077-7229
Titre abrégé: Cogn Behav Pract
Pays: United States
ID NLM: 9440144
Informations de publication
Date de publication:
Feb 2020
Feb 2020
Historique:
entrez:
11
3
2020
pubmed:
11
3
2020
medline:
11
3
2020
Statut:
ppublish
Résumé
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.
Identifiants
pubmed: 32153343
doi: 10.1016/j.cbpra.2018.10.003
pmc: PMC7062310
mid: NIHMS1522158
doi:
Types de publication
Journal Article
Langues
eng
Pagination
84-92Subventions
Organisme : Medical Research Council
ID : MR/R010161/1
Pays : United Kingdom
Organisme : NIMH NIH HHS
ID : R21 MH094156
Pays : United States
Déclaration de conflit d'intérêts
The authors declare that there are no conflicts of interest.
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