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Background: Adolescents living with Human Immunodeficiency Virus (HIV) have an increased risk of depression, negatively affecting their adherence to antiretroviral therapy (ART) and treatment outcomes. Integrating mental health care in HIV care and treatment settings improves comprehensive care. However, integration remains challenging in Tanzania, like in other high-burden and low-resource settings. The overall objective of this work is to inform the development of a psychological intervention for depression in adolescents living with HIV (ALWHIV). We describe perceived barriers and opportunities for implementing an integrated, evidence-based psychological intervention to manage adolescent depression in HIV care and treatment centers (HIV-CTC) from the perspectives of adolescents, caregivers, and healthcare providers (HCPs) in Dar es Salaam, Tanzania.

Methods: To inform intervention development and implementation, this study utilized a qualitative design through a phenomenological approach informed by the Consolidated Framework for Implementation Research (CFIR) to explore implementation barriers and facilitators in ALWHIV, HCPs, and caregivers. Forty-five in-depth interviews were conducted in three HIV-CTCs in Kinondoni Dar es Salaam. Audio records were transcribed verbatim and analyzed deductively through NVIVO software.

Results: Barriers to implementing an integrated psychological intervention to address depression in ALWHIV included (A) poor mental health awareness among caregivers, adolescents, HCPs, and policy-makers, (B) high level of stigma against mental health care, (C) poor communication between adolescents and HCPs concerning mental health care, (D) lack of contextualized intervention of proven effectiveness and guidelines of mental health care, and (E) inadequate mental health care supportive supervision and mentorship. Facilitators for implementation included supportive infrastructure, positive pressure from HIV implementing partners, tension for change, and participant's perception of the advantage of a psychological intervention as compared to just usual HIV care and treatment counseling.

Conclusion: Despite several modifiable barriers to implementing a psychological intervention in HIV CTC, there were encouraging facilitators and opportunities for implementing an integrated, evidence-based psychological intervention to address depression in ALWHIV in Kinondoni Dar es Salaam, Tanzania.

Titel:	Perceived barriers and opportunities for implementing an integrated psychological intervention for depression in adolescents living with HIV in Tanzania.
Autor/in / Beteiligte Person:	Njau, T ; Mwakawanga, DL ; Sunguya, B ; Minja, A ; Kaaya, S ; Fekadu, A
Link:	Full Text Finder (Volltext)
Zeitschrift:	BMC health services research, Jg. 24 (2024-05-28), Heft 1, S. 672
Veröffentlichung:	London : BioMed Central, [2001-, 2024
Medientyp:	academicJournal
ISSN:	1472-6963 (electronic)
DOI:	10.1186/s12913-024-11118-5
Schlagwort:	Humans Adolescent Tanzania Male Female Psychosocial Intervention methods Caregivers psychology Social Stigma Interviews as Topic Delivery of Health Care, Integrated organization & administration HIV Infections psychology HIV Infections therapy Qualitative Research Depression therapy Depression psychology
Sonstiges:	Nachgewiesen in: MEDLINE Sprachen: English Publication Type: Journal Article Language: English [BMC Health Serv Res] 2024 May 28; Vol. 24 (1), pp. 672. <i>Date of Electronic Publication: </i>2024 May 28. MeSH Terms: HIV Infections* / psychology ; HIV Infections* / therapy ; Qualitative Research* ; Depression* / therapy ; Depression* / psychology ; Humans ; Adolescent ; Tanzania ; Male ; Female ; Psychosocial Intervention / methods ; Caregivers / psychology ; Social Stigma ; Interviews as Topic ; Delivery of Health Care, Integrated / organization & administration References: Epidemiol Psychiatr Sci. 2012 Mar;21(1):47-57. (PMID: 22670412) ; AIDS Res Ther. 2021 Apr 27;18(1):23. (PMID: 33906698) ; J Acquir Immune Defic Syndr. 2012 Feb 1;59(2):161-9. (PMID: 22138766) ; Implement Sci. 2006 Oct 26;1:26. (PMID: 17067388) ; PLoS One. 2016 Nov 16;11(11):e0165936. (PMID: 27851797) ; Implement Sci. 2009 Aug 07;4:50. (PMID: 19664226) ; J Acquir Immune Defic Syndr. 2016 Jan 1;71(1):38-46. (PMID: 26761270) ; J Int AIDS Soc. 2013 Jun 18;16:18593. (PMID: 23782478) ; Trop Med Int Health. 2009 Oct;14(10):1226-32. (PMID: 19732408) ; Clin Child Psychol Psychiatry. 2012 Oct;17(4):482-94. (PMID: 22523137) ; J Affect Disord. 2014 Apr;158:78-84. (PMID: 24655769) ; World Psychiatry. 2008 Feb;7(1):39-46. (PMID: 18458786) ; J Acquir Immune Defic Syndr. 2007 Apr 1;44(4):470-7. (PMID: 17179766) ; J Int Assoc Provid AIDS Care. 2014 Jul-Aug;13(4):346-52. (PMID: 24114726) ; J Int AIDS Soc. 2017 May 16;20(Suppl 3):21569. (PMID: 28530046) ; Lancet. 2007 Sep 29;370(9593):1164-74. (PMID: 17804061) ; Soc Psychiatry Psychiatr Epidemiol. 2016 Jan;51(1):81-92. (PMID: 26433379) ; Pediatrics. 2006 Jul;118(1):189-200. (PMID: 16818565) ; Int J Ment Health Syst. 2016 Jul 22;10:49. (PMID: 27453722) ; Implement Sci. 2008 Jan 07;3:1. (PMID: 18179688) ; J Adolesc Health. 2016 Oct;59(4S):S49-S60. (PMID: 27664596) ; J Acquir Immune Defic Syndr. 2011 Oct 1;58(2):181-7. (PMID: 21857529) ; Vulnerable Child Youth Stud. 2010 Jun;5(2):174-187. (PMID: 20808733) ; PLoS Med. 2009 Oct;6(10):e1000159. (PMID: 19806179) ; Implement Sci. 2007 Nov 30;2:40. (PMID: 18053122) ; J Consult Clin Psychol. 2012 Jun;80(3):404-15. (PMID: 22545737) ; Int J Soc Psychiatry. 2008 Mar;54(2):180-90. (PMID: 18488410) ; BMC Psychiatry. 2016 May 26;16:164. (PMID: 27228979) ; J Int AIDS Soc. 2015 Sep 16;18:20049. (PMID: 26385853) ; Int J Ment Health Syst. 2016 Aug 04;10:50. (PMID: 27493684) ; J Int AIDS Soc. 2017 May 16;20(Suppl 3):21497. (PMID: 28530045) ; J Int Assoc Provid AIDS Care. 2015 Mar-Apr;14(2):108-11. (PMID: 25376926) ; Int J Qual Health Care. 2007 Dec;19(6):349-57. (PMID: 17872937) ; Transcult Psychiatry. 2014 Dec;51(6):759-76. (PMID: 25358524) ; J Int Assoc Provid AIDS Care. 2014 Jan-Feb;13(1):78-84. (PMID: 23269515) ; J Cogn Psychother. 2010 Nov 1;24(4):329-343. (PMID: 23667294) ; Depress Res Treat. 2017;2017:9109086. (PMID: 29333294) ; J Int AIDS Soc. 2021 Apr;24(4):e25695. (PMID: 33838007) ; Nurse Educ Today. 2004 Feb;24(2):105-12. (PMID: 14769454) ; BMC Psychiatry. 2015 Feb 12;15:19. (PMID: 25886524) ; PLoS Med. 2006 Nov;3(11):e442. (PMID: 17132052) ; AIDS Care. 2012;24(3):319-23. (PMID: 22273005) ; PLoS One. 2014 Feb 18;9(2):e88437. (PMID: 24558389) ; Lancet. 2007 Apr 14;369(9569):1302-1313. (PMID: 17434406) ; AIDS Care. 2016 Jul;28(7):825-33. (PMID: 26837437) ; Adm Policy Ment Health. 2015 Sep;42(5):533-44. (PMID: 24193818) ; AIDS Behav. 2018 Jan;22(1):86-101. (PMID: 28063075) ; Behav Res Ther. 2014 Sep;60:53-9. (PMID: 25064211) ; Qual Health Res. 2015 May;25(5):587-8. (PMID: 25829508) ; Curr HIV/AIDS Rep. 2014 Sep;11(3):291-307. (PMID: 25038748) ; Child Adolesc Psychiatr Clin N Am. 2019 Jul;28(3):447-459. (PMID: 31076119) Contributed Indexing: Keywords: Adolescents; Depression; HIV/AIDS; Implementation; Integrated care; Mental health; Psychological intervention Entry Date(s): Date Created: 20240528 Date Completed: 20240529 Latest Revision: 20240531 Update Code: 20240531 PubMed Central ID: PMC11134697

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Perceived barriers and opportunities for implementing an integrated psychological intervention for depression in adolescents living with HIV in Tanzania.