Evidence map›Paper›PMID 34164926›Full record

SynthesisJournal of the International AIDS Society2021

Mental health interventions for persons living with HIV in low- and middle-income countries: a systematic review.

Etheldreda Nakimuli-Mpungu, Seggane Musisi, Colin M Smith, Megan Von Isenburg, Benedict Akimana, Ani Shakarishvili, Jean B Nachega, Edward J Mills, Dixon Chibanda, Marcelo Ribeiro and 2 more

Abstract readSystematic Review
In one paragraph

Synthesis in Journal of the International AIDS Society, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 40 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
40citing papers in PubMed, 3 pooled it
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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

40 citing papers in PubMed, 3 syntheses or guidelines pooled it.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Etheldreda Nakimuli-MpunguDepartment of Psychiatry, College of Health Sciences, Makerere University, Kampala, Uganda.ORCID 0000-0001-6857-8931
Seggane MusisiDepartment of Psychiatry, College of Health Sciences, Makerere University, Kampala, Uganda.ORCID 0000-0002-3454-0000
Colin M SmithDepartment of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA.ORCID 0000-0002-5758-4698
Megan Von IsenburgDuke University Medical Center Library, Duke University Medical Center, Durham, NC, USA.ORCID 0000-0001-6084-5775
Benedict AkimanaThe Butabika National Referral Hospital, Ministry of Health, Kampala, Uganda.ORCID 0000-0001-8522-1440
Ani ShakarishviliThe Joint United Nations Programme on HIV/AIDS, Geneva, Switzerland.
Jean B NachegaDepartment of International Health, Bloomberg's School of Public Health, Johns Hopkins University, Baltimore, MD, USA.
Edward J MillsDepartment of Clinical Epidemiology & Biostatistics, McMaster University, Hamilton, ON, Canada.ORCID 0000-0003-3120-9694
Dixon ChibandaZimbabwe AIDS Prevention Project, Department of Community Medicine, University of Zimbabwe, Harare, Zimbabwe.ORCID 0000-0003-2505-8607
Marcelo RibeiroReference Center for Alcohol, Tobacco and Other Drugs (CRATOD), São Paulo State Secretary of Health, São Paulo, Brazil.ORCID 0000-0003-1167-5559
Anna V WilliamsNational Addiction Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK.
John A JoskaHIV Mental Health Research Unit, Department of Psychiatry, Neuroscience Institute, University of Cape Town, Cape Town, South Africa.ORCID 0000-0003-4260-1181

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionAddressing the intersection between mental health and HIV is critical for the wellbeing of persons living with HIV (PLWH). This systematic review synthesized the literature on mental health interventions for PLWH in low- and middle-income countries (LMICs) to determine intervention components and explore their relationship with intervention effectiveness.

methodsWe included only controlled clinical trials of interventions aiming to improve the mental health of PLWH. We conducted a search in the following databases: PubMed, CINAHL, PsycINFO and EMBASE for eligible studies describing the evaluation of interventions for mental health problems among PLWH in LMICs published through August 2020. Two reviewers independently screened references in two successive stages of title/abstract screening and then full-text screening for references meeting title/abstract criteria.

resultsWe identified a total of 30 eligible articles representing 6477 PLWH who were assigned to either the intervention arm (n = 3182) or control arm (n = 3346). The mental health interventions evaluated were psychological (n = 17, 56.67%), pharmacological (n = 6, 20.00%), combined psychological and pharmacological (n = 1, 3.33%) and complementary/alternative treatments (n = 6, 20.00%). The mental health problems targeted were depression (n = 22, 73.33 %), multiple psychological symptoms (n = 1, 3.33%), alcohol and substance use problems (n = 4, 13.33%), post-traumatic stress disorder (n = 1, 3.33%) and HIV-related neuro-cognitive impairment (n = 2, 6.67%). Studies of interventions with significant effects had significantly a higher number of active ingredients than those without significant effects [3.41 (2.24) vs. 1.84 (1.46) Mean (SD)] [Mean difference = -1.56, 95% CI = -3.03 to -0.09, p = 0.037].

conclusionsThere continue to be advances in mental health interventions for PLWH with mental illness in LMICs. However, more research is needed to elucidate how intervention components lead to intervention effectiveness. We recommend scale up of culturally appropriate interventions that have been successfully evaluated in low- and middle-income countries.

Indexed as

HIV InfectionsStress Disorders, Post-TraumaticDeveloping CountriesHumansMental HealthPsychotherapyanti-retroviral therapy theory of changeHIV/AIDSlow- and middle-income countriesmental healthpsychotherapypsychotropic

Identifiers

PMID34164926
PMCPMC8222847

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.