A pilot study of a nurse-delivered cognitive behavioral therapy intervention (Ziphamandla) for adherence and depression in HIV in South Africa.
Depression is prevalent among people living with HIV in South Africa and interferes with adherence to antiretroviral therapy. This study evaluated a nurse-delivered, cognitive behavioral therapy intervention for adherence and depression among antiretroviral therapy users with depression in South Africa ( n = 14). Primary outcomes were depression, antiretroviral therapy adherence, feasibility, and acceptability. Findings support robust improvements in mood through a 3-month follow up. Antiretroviral therapy adherence was maintained during the intervention period. Participant retention supports acceptability; however, modest provider fidelity despite intensive supervision warrants additional attention to feasibility. Future effectiveness research is needed to evaluate this nurse-delivered cognitive behavioral therapy intervention for adherence and depression in this context.
1 University of Cape Town, South Africa.
Lena S
LS
Andersen
2 Massachusetts General Hospital/ Harvard Medical School, USA.
Jessica F
JF
Magidson
2 Massachusetts General Hospital/ Harvard Medical School, USA.|3 Fenway Health, USA.
Conall
C
O'Cleirigh
2 Massachusetts General Hospital/ Harvard Medical School, USA.
Jessica E
JE
Remmert
4 Stellenbosch University, South Africa.
Ashraf
A
Kagee
1 University of Cape Town, South Africa.
Matthew
M
Leaver
1 University of Cape Town, South Africa.|5 Medical Research Council Unit on Anxiety and Stress Disorders, South Africa.
Dan J
DJ
Stein
6 University of Miami, USA.
Steven A
SA
Safren
1 University of Cape Town, South Africa.
John
J
Joska
D000328:Adult; D019380:Anti-HIV Agents / Q000008:administration & dosage*; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D065246:Culturally Competent Care; D003866:Depressive Disorder / Q000451:nursing* / Q000523:psychology; D005240:Feasibility Studies; D005260:Female; D015658:HIV Infections / Q000188:drug therapy / Q000451:nursing* / Q000523:psychology; D006801:Humans; D008297:Male; D055118:Medication Adherence / Q000523:psychology*; D008875:Middle Aged; D009722:Nurse Practitioners; D010342:Patient Acceptance of Health Care; D010865:Pilot Projects; D013019:South Africa
D019380:Anti-HIV Agents
HIV; South Africa; adherence; cognitive behavioral therapy; depression; low- and middle-income countries; task-sharing