The effectiveness of depression management for improving HIV care outcomes in Malawi: protocol for a quasi-experimental study

BMC Public Health

Brian W. Pence¹  Melissa A. Stockton¹  Kazione Kulisewa²  Bradley N. Gaynes³  Michael Udedi⁴  Mina C. Hosseinipour⁵  Steven M. Mphonda⁵ 

[1] Department of Epidemiology, University of North Carolina at Chapel Hill, Gillings School of Global Public Health;Department of Mental Health, University of Malawi, College of Medicine;Department of Psychiatry, University of North Carolina at Chapel Hill School of Medicine;NCDs and Mental Health Unit, Ministry of Health;Tidziwe Centre, University of North Carolina Project-Malawi;

关键词: HIV/AIDS;    Mental health;    Depression;    Sub-Saharan Africa;    Malawi;    Integration;   

DOI  :  10.1186/s12889-019-7132-3

来源: DOAJ

【 摘 要 】

Abstract Background Depression, prevalent among people living with HIV (PLWH) in Malawi, is associated with negative HIV patient outcomes and likely affects HIV medical management. Despite the high prevalence of depression, its management has not been integrated into HIV care in Malawi or most low-income countries. Methods This study employs a pre-post design in two HIV clinics in Lilongwe, Malawi, to evaluate the effect of integrating depression management into routine HIV care on both mental health and HIV outcomes. Using a multiple baseline design, this study is examining mental health and HIV outcome data of adult (≥18 years) patients newly initiating ART who also have depression, comparing those entering care before and after the integration of depression screening and treatment into HIV care. The study is also collecting cost information to estimate the cost-effectiveness of the program in improving rates of depression remission and HIV treatment engagement and success. Discussion We anticipate that the study will generate evidence on the effect of depression management on HIV outcomes and the feasibility of integrating depression management into existing HIV care clinics. The results of the study will inform practice and policy decisions on integration of depression management in HIV care clinics in Malawi and related settings, and will help design a next-step strategy to scale-up integration to a larger scale. Trial registration ClinicalTrials.gov ID [NCT03555669]. Retrospectively registered on 13 June 2018.

【 授权许可】

Unknown