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Sponsor: Massachusetts General Hospital
Conditions: HIV Infections
Interventions: Cognitive Behavioral Therapy for Syndemics and Adherence (CBT-SA)
Countries: South Africa
In South Africa, the country with the highest HIV prevalence (19%), co-occurring problems such as depression, post-traumatic stress, and food insecurity interact to enhance one another (i.e., syndemic problems) and are associated with worse HIV outcomes such as worse antiretroviral therapy (ART) adherence and worse viral load. This study proposes to: 1) explore how syndemic problems work together to make health worse for people with HIV (PWH) and explore what people think about a potential treatment; 2) develop a treatment to address syndemic problems and improve ART adherence (CBT-SA); 3a) assess whether people are willing to receive the CBT-SA we it can actually be done; and 3b) identify factors that make it easier or more difficult to receive CBT-SA.
Sex: ALL
Age: 18 Years to —
Healthy volunteers: No
Study type: INTERVENTIONAL
Inclusion Criteria: 1. Patient receiving HIV care in Khayelitsha (confirmed by medical record) 2. Currently prescribed TDF-based ART, with recent difficulties with ART adherence (self-reported in past 30 days / confirmed by pharmacy refill data) 3. Mild, moderate, or severe food insecurity (measured by HFIAS categories) AND ≥1 of the following: * Clinically significant depressive symptoms (CES-D ≥ 16) * Clinically significant post-traumatic stress symptoms (SPAN ≥ 5) 4. 18 years of age or older Exclusion Criteria: 1. Unable or unwilling to provide informed consent 2. In the past year: received CBT for depression or PTSD, or received supplemental food parcels or nutritional counseling 3. Current untreated or undertreated serious mental health issue that would interfere with participation
- Cape Town, Western Cape, South Africa