ArticlePloS one2020
The impact of an integrated depression and HIV treatment program on mental health and HIV care outcomes among people newly initiating antiretroviral therapy in Malawi.
Article in PloS one, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 41 papers, 3 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
41 citing papers in PubMed, 3 syntheses or guidelines pooled it, 78 citations in OpenAlex.
- Global Systematic Review of Common Mental Health Disorders in Adults Living with HIV.Current HIV/AIDS reports · 2021Pooled it
- Integrating HIV services and other health services: A systematic review and meta-analysis.PLoS medicine · 2021Pooled it
- Mental health interventions for persons living with HIV in low- and middle-income countries: a systematic review.Journal of the International AIDS Society · 2021Pooled it
- Addressing depression, stress, and hopelessness through an economic and relationship-strengthening intervention: Findings from a pilot randomized controlled trial among people with HIV in Malawi.Journal of affective disorders · 2026Trial
- Two implementation strategies to support the integration of depression screening and treatment into hypertension and diabetes care in Malawi (SHARP): parallel, cluster-randomised, controlled, implementation trial.The Lancet. Global health · 2024Trial
- Depressive disorder at the household level: prevalence and correlates of depressive symptoms among household members.Global health action · 2023Trial
- Long-Term Effect of Group Support Psychotherapy on Depression and HIV Treatment Outcomes: Secondary Analysis of a Cluster Randomized Trial in Uganda.Psychosomatic medicine · 2022Trial
- Depression management and antiretroviral treatment outcome among people living with HIV in Northwest and East regions of Cameroon.BMC infectious diseases · 2022Trial
- Provider- and patient-level costs associated with providing antiretroviral therapy during the postpartum phase to women living with HIV in South Africa: A cost comparison of three postpartum models of care.Tropical medicine & international health : TM & IH · 2020Trial
- Strategies to integrate non-communicable disease interventions in HIV and tuberculosis care contexts in low- and middle-income countries: a scoping review.BMJ global health · 2026Article
- Validation of Shona Symptom Questionnaire (SSQ-14), Patient Health Questionnaire (PHQ-9) and Generalised Anxiety Disorder scale (GAD-7) in Unguja Island, Zanzibar.BMC psychology · 2025Article
- Cultural adaptation of clinic-based pediatric hiv status disclosure intervention with task shifting in Eastern Uganda.AIDS research and therapy · 2025Article
- The impact of syndemic burden, age, and sexual minority status on internalized HIV stigma among people living with HIV in South Florida.Journal of health psychology · 2025Article
- Prevalence of Depression Among People Living with HIV on Antiretroviral Therapy in Africa: A Systematic Review and Meta-Analysis.Healthcare (Basel, Switzerland) · 2025Review
- Evaluating implementation research outcomes for a task-sharing mental health intervention: A systematic review of the Friendship Bench.Global mental health (Cambridge, England) · 2025Review
- Integration of mental health and HIV service delivery in low- and middle-income countries: A systematic review of effectiveness.Global mental health (Cambridge, England) · 2025Review
- Barriers and facilitators to integrating the friendship bench into non-communicable disease care in Malawi: A qualitative study.PLOS mental health · 2025Article
- Integrating a mental health intervention into PrEP services for South African young women: a human-centred implementation research approach to intervention development.Journal of the International AIDS Society · 2024Article
- Acceptability of a Randomized Trial of Anti-depressant Medication or Interpersonal Therapy for Treatment of Perinatal Depression in Women with HIV.AIDS and behavior · 2024Article
- Phone-based psychosocial counseling for people living with HIV: Feasibility, acceptability and impact on uptake of psychosocial counseling services in Malawi.Global mental health (Cambridge, England) · 2024Article
Corrections and comments
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Authors and funding
12 authors at 3 institutions in 2 countries.
Funding
Abstract
backgroundDepression is highly prevalent among patients newly starting antiretroviral treatment (ART) in Malawi and many other countries. Untreated depression at ART initiation can disrupt the HIV care continuum. Effective approaches for depression screening and treatment exist for low-resource settings, but they are rarely applied. Identifying effective implementation strategies are critical.
methodsA pilot program integrated depression screening and treatment into routine HIV care using existing staff at two public health clinics in Malawi in two phases; a screening-only "control" phase and an active "intervention" phase. During the intervention phase, providers prescribed antidepressants or referred patients for Friendship Bench problem-solving therapy. We evaluated the program's impact on retention in HIV care, viral suppression, and depression remission at 6 months using tabular comparisons and log-binomial models to estimate adjusted risk ratios and mean differences among the intervention group relative to the control group.
resultsNearly all consenting participants were screened for depression appropriately and 25% had mild to severe depressive symptoms. During the intervention phase, 86% of participants with mild depressive symptoms started Friendship Bench therapy and 96% of participants with moderate to severe depressive symptoms started antidepressants. Few participants in the intervention group received consistent depression treatment over their first 6 months in care. In the adjusted main analysis, program exposure did not demonstrably affect most HIV or mental health outcomes, though the probability of currently being on ART at 6 months was significantly lower among the intervention group than the control group [RR 0.6(95%CI: 0.4-0.9)].
conclusionsWhile it is feasible to integrate depression screening and treatment initiation into ART initiation, providing ongoing depression treatment over time is challenging. Similar implementation science studies focused on maintaining depression management will be increasingly important as we strive to understand and test the best ways to implement evidence-based depression treatment within HIV care.
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Registered trials
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