Completed Mental Health Pregnancy, Children & Inherited Conditions

Integrating the management of depression into routine HIV care in Uganda (the HIV+D trial)

Funder Wellcome Charity-funded
Recipient organisation MRC/UVRI Uganda Research Unit on AIDS
Funding £2.0M
Period Feb 2017 — Feb 2022

In plain English

AI plain-English summary

In Uganda, lay health workers will screen people with HIV for depression and deliver therapy or medication as part of routine HIV care. This matters because depression is common among people living with HIV, yet mental health services are largely absent from HIV clinics across sub-Saharan Africa. The standard model—referring patients to specialist mental health workers—fails because those specialists are scarce. The project adapts a proven Indian collaborative care model, called MANAS, to Uganda’s HIV care system. It trains lay health workers to deliver a structured therapy program and coordinate antidepressant use, with support from the existing HIV care team and occasional specialist input. If the trial succeeds, it could transform how depression is managed in HIV care across low-resource settings. Instead of a separate, inaccessible mental health system, depression treatment would become a routine part of the clinic visit—no different from checking viral load or dispensing antiretrovirals. This would close the treatment gap for millions of people with HIV who currently receive no mental health care at all. The research also tests cost-effectiveness, so funders and governments can decide whether to scale the model nationally.

View original technical description
This project aims to demonstrate the feasibility and effectiveness of a mental health integration model in general adult HIV care services to bridge the treatment gap for mental disorders in HIV/AIDS that currently exists in most of sub-Saharan Africa. The proposed model will be based on the MANAS intervention which is stepped care collaborative care delivery model coordinated by a lay health worker for depressive and anxiety disorders in public primary health care attenders in India. This study will have the following objectives: i) to adapt the MANAS collaborative stepped care intervention to the general HIV care situation of Uganda, including the local adapatation of the Health Activity Program (HAP) therapy for depression; ii) to undertake a cluster randomised trial to evaluate the effectiveness on depressive disorders (DD) and functional outcomes and cost-effectiveness of the intervention in routine HIV care in Uganda. This study will be undertaken among persons living with HIV attending public health care facilities in three districts of Uganda. The planned intervention will involve screening for DD, psychoeducation, administration of HAP and use of antidepressant medication to be delivered by lay health workers, the HIV care team with support from specialist mental health workers.

View the original record at the funder ↗

Researchers

Eugene Kinyanda (EPMC Awardee)

Related Research

Grants with similar aims, by meaning.

Pilot of an Intervention for Malawian Pregnant Women with HIV to Improve Depression, Viral Suppression and Engagement of Partners in HIV Self-Testing
Strengthening South Africa's health system through integrating treatment for mental illness into chronic disease care (Project MIND)
The effects of group support psychotherapy delivered by lay health workers on depression among persons living with HIV in Northern Uganda
E Kinyanda, MRC/UVRI Uganda Research Unit on AIDS - Mental health among HIV infected CHildren and Adolescents in KAmpala, Uganda (CHAKA)
Uptake and impact of HIV combination (HIVCOMB) interventions on HIV incidence among fishing communities in Uganda

Original classification

Senior Research Fellowship in PH&TM

Plain English summaries and category classifications on this site are generated by AI and may not perfectly reflect the original research.