Article and Study Summary:
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.
Published in:
PLOS Glob Public Health. 2024;4(1):e0001492.
https://doi.org/10.1371/journal.pgph.0001492
Authors:
Simms V, Abas MA, Müller M, et al.
Summary
This multi-center, prospective, comparative cohort study evaluated the effect of the Friendship Bench (FB) psychological intervention on HIV viral suppression among people living with HIV (PLWH) with co-morbid common mental disorders (CMD) in Zimbabwe. PLWH who were ≥18 years old, on antiretroviral therapy (ART) for at least three months and found to have co-morbid CMD diagnosed using the Shona Symptom Questionnaire (SSQ-14) were included in the study. Participants from six clinics received the FB intervention, which included six sessions of culturally adapted problem-solving therapy and simple behavioral activation for depression, delivered by a trained lay counsellor on a bench in a discreet area outside the clinic. Participants at two clinics served as the comparison group and received enhanced usual care (EUC), which consisted of nurse-led psychoeducation and assessment with referral for any additional mental health care needs. The primary outcome was the proportion of participants with viral non-suppression (defined as ≥400 copies/mL) at six months follow-up or death. Overall, 10.1% of the participants in the FB group had viral non-suppression at endline as compared to 15.1% in the EUC group (p = 0.05). Among participants who were virally suppressed at baseline, prevalence of non-suppression at follow-up was lower in the FB group than the EUC group, however, among participants with viral non-suppression at baseline, there was no evidence of a difference in endline viral non-suppression between the groups. These findings suggest the FB is a promising intervention to help PLWH with CMD to maintain viral suppression, but more is needed to support those who are struggling with non-adherence.
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