Effect of a brief psychological intervention for common mental disorders on HIV viral suppression

A non-randomised controlled study of the Friendship Bench in Zimbabwe

Bibliographic Data

ID19594614
AuthorsVictoria Simms (0000-0001-5664-6810, London School of Hygiene & Tropical Medicine, corresponding author), Melanie Abas (0000-0003-1716-5584, King's College London, corresponding author), Monika Müller (0000-0001-7792-8227, King's College London, corresponding author), Epiphania Munetsi (0000-0001-9174-3827, corresponding author), Lloyd Dzapasi (corresponding author), Helen A Wei (0000-0003-3547-7936, London School of Hygiene & Tropical Medicine, corresponding author), Helen A Weiss, Dixon Chibanda (0000-0003-2505-8607, University of Zimbabwe, corresponding author)
EditorsSiyan Yi (0000-0002-3045-5386)
Year2024
Volume4
Issue1
Pagese0001492
Publication date2024-01-18
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenuePLOS Global Public Health (JOURNAL)
Journal identifiersISSN: 2767-3375 • E-ISSN: 2767-3375
PublisherPublic Library of Science (PLoS) (PUBLISHER)
DOI10.1371/journal.pgph.0001492
PMID38236786
OpenAlexW4390971179
LanguageEN
Citations received6
References cited31

Background For people living with co-morbid HIV and common mental disorders (CMD), it is not known whether a brief psychological intervention for CMD can improve HIV viral suppression. Methods We conducted a prospective cohort study in eight primary care clinics in Harare, Zimbabwe, enrolling adults with co-morbid HIV and CMD. Six clinics provided the Friendship Bench (FB), a brief psychological intervention for CMD based on problem-solving therapy, delivered by lay counsellors. Two clinics provided enhanced usual care (EUC). The primary outcome was viral non-suppression after six months (viral load ≥400 copies/mL). Data were analysed using a difference-in-difference approach with linear regression of cluster-level proportions, adjusted for baseline viral non-suppression (aDiD). The secondary outcome was presence of CMD measured by the Shona Symptom Questionnaire. Results In FB clinics, 407/500 (81.4%) participants had viral load results at baseline and endline: 58 (14.3%) had viral non-suppression at baseline and 41 (10.1%) at endline. In EUC clinics, 172/200 (86.0%) had viral load results at baseline and endline: 22 (12.8%) were non-suppressed at baseline and 26 (15.1%) at endline (aDiD = -7.3%; 95%CI 14.7% to -0.01%; p = 0.05). Of the 499 participants virally suppressed at baseline, the FB group had lower prevalence of non-suppression at endline compared to the EUC group (2.9% vs 9.3%; p = 0.002). There was no evidence of a difference in endline viral non-suppression by group among the 80 participants with non-suppression at baseline (53.5% vs 54.6%; p = 0.93). The FB group was less likely to screen positive for CMD at endline than the EUC group (aDiD = -21.6%; 95%CI -36.5% to -6.7%; p = 0.008). Conclusion People living with co-morbid HIV and CMD may benefit from receiving a low-cost mental health intervention to enhance viral suppression, especially if they are already virally suppressed. Research is needed to understand if additional adherence counselling could further improve viral suppression

Cohort · Cohort study · Mental health · Prospective cohort study · Psychiatry · Psychological intervention · Viral load · Counseling, Therapy, and Family Dynamics · Family Caregiving in Mental Illness · HIV/AIDS Research and Interventions · Medicine · Immunology · Internal Medicine