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Effectiveness of a peer-led adolescent mental health intervention on HIV virological suppression and mental health in Zimbabwe: protocol of a cluster-randomised trial
Global Mental Health ( IF 3.9 ) Pub Date : 2020-08-28 , DOI: 10.1017/gmh.2020.14
Silindweyinkosi Chinoda 1 , Abigail Mutsinze 2 , Victoria Simms 3 , Rhulani Beji-Chauke 1 , Ruth Verhey 1 , Joanna Robinson 4 , Taryn Barker 4 , Owen Mugurungi 5 , Tsitsi Apollo 5 , Epiphany Munetsi 1 , Dorcas Sithole 6 , Helen A Weiss 3 , Dixon Chibanda 1, 7, 8 , Nicola Willis 2
Affiliation  

Background Adolescents living with HIV (ALHIV) experience a high burden of mental health disorder which is a barrier to antiretroviral therapy adherence. In Zimbabwe, trained, mentored peer supporters living with HIV (Community Adolescent Treatment Supporters – CATS) have been found to improve adherence, viral suppression and psychosocial well-being among ALHIV. The Friendship Bench is the largest integrated mental health programme in Africa. We hypothesise that combining the CATS programme and Friendship Bench will improve mental health and virological suppression among ALHIV compared with the CATS programme alone. Methods We will conduct a cluster-randomised controlled trial in 60 clinics randomised 1:1 in five provinces. ALHIV attending the control arm clinics will receive standard CATS support and clinic support following the Ministry of Health guidelines. Those attending the intervention arm clinics will receive Friendship Bench problem-solving therapy, delivered by trained CATS. Participants with the signs of psychological distress will be referred to the clinic for further assessment and management. The primary outcome is HIV virological failure (≥1000 copies/ml) or death at 48 weeks. Secondary outcomes include the proportion of adolescents with common mental disorder symptoms (defined as Shona Symptom Questionnaire (SSQ-14) score ≥8), proportion with depression symptoms (defined as Patient Health Questionnaire (PHQ-9) score ≥11), symptom severity (mean SSQ-14 and PHQ-9 scores) and EQ-5D score for health-related quality of life. Conclusions This trial evaluates the effectiveness of peer-delivery of mental health care on mental health and HIV viral load among ALHIV. If effective this intervention has the potential to be scaled-up to improve these outcomes. Trial registration: PACTR201810756862405. 08 October 2018.

中文翻译:

同伴主导的青少年心理健康干预对津巴布韦 HIV 病毒学抑制和心理健康的有效性:集群随机试验方案

背景 感染 HIV 的青少年 (ALHIV) 承受着沉重的心理健康障碍负担,这是抗逆转录病毒治疗依从性的障碍。在津巴布韦,已发现经过培训、指导的艾滋病病毒感染者同伴支持者(社区青少年治疗支持者 - CATS)可以改善 ALHIV 的依从性、病毒抑制和社会心理健康。Friendship Bench 是非洲最大的综合心理健康项目。我们假设与单独的 CATS 计划相比,将 CATS 计划和 Friendship Bench 相结合将改善 ALHIV 的心理健康和病毒学抑制。方法 我们将在 5 个省份的 60 家诊所按 1:1 随机进行整群随机对照试验。参加控制组诊所的 ALHIV 将根据卫生部的指导获得标准的 CATS 支持和诊所支持。那些参加干预臂诊所的人将接受由训练有素的 CATS 提供的友谊长椅问题解决疗法。有心理困扰迹象的参与者将被转介到诊所进行进一步评估和管理。主要结果是 48 周时 HIV 病毒学失败(≥1000 拷贝/ml)或死亡。次要结果包括患有常见精神障碍症状的青少年比例(定义为 Shona 症状问卷 (SSQ-14) 评分≥8)、抑郁症状比例(定义为患者健康问卷 (PHQ-9) 评分≥11)、症状严重程度(平均 SSQ-14 和 PHQ-9 分数)和健康相关生活质量的 EQ-5D 分数。结论 本试验评估了精神卫生护理的同伴提供对 ALHIV 的精神健康和 HIV 病毒载量的有效性。如果有效,这种干预有可能扩大规模以改善这些结果。试用注册:PACTR201810756862405。2018 年 10 月 8 日。
更新日期:2020-08-28
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