Evidence map›Paper›PMID 40914533›Full record

Trial reportJournal of affective disorders2026

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.

Natalia Van Doren, Nancy Mulauzi, Scott Tebbetts, James Mkandawire, Torsten B Neilands, Fred Ssewamala, Derek D Satre, Amy A Conroy

Abstract readRandomized Controlled Trial
In one paragraph

Trial report in Journal of affective disorders, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
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

1 citing paper in PubMed.

  1. Review
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

8 authors.

Natalia Van DorenDepartment of Psychiatry and Behavioral Sciences, University of California, San Francisco, CA, USA; Division of Research, Kaiser Permanente Northern California, Pleasanton, CA, USA. Electronic address: natalia.vandoren@ucsf.edu.
Nancy MulauziInvest in Knowledge, Zomba, Malawi.
Scott TebbettsCenter for AIDS Prevention Studies, Division of Prevention Sciences, Department of Medicine, University of California, San Francisco, CA, USA.
James MkandawireInvest in Knowledge, Zomba, Malawi.
Torsten B NeilandsCenter for AIDS Prevention Studies, Division of Prevention Sciences, Department of Medicine, University of California, San Francisco, CA, USA.
Fred SsewamalaWashington University, Brown School, St. Louis, MO, USA.
Derek D SatreDepartment of Psychiatry and Behavioral Sciences, University of California, San Francisco, CA, USA; Division of Research, Kaiser Permanente Northern California, Pleasanton, CA, USA.
Amy A ConroyCenter for AIDS Prevention Studies, Division of Prevention Sciences, Department of Medicine, University of California, San Francisco, CA, USA.

Funding

Substance Use Disorders Treatment/Services Research Training ProgramT32DA007250 · NIDA · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI Derek D Satre, Janice Y Tsoh · 1991 to 2026
$7.4M
Mentoring alcohol use intervention research in HIV health care settingsK24AA025703 · NIAAA · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI Derek D Satre · 2018 to 2026
$1.8M
An economic and relationship-strengthening intervention for HIV-affected couples who drink alcohol in Malawi - Administrative SupplementR34AA027983 · NIAAA · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI CONROY, AMY ANNE · 2019 to 2022
$784k
NIAAA NIH HHS K24 AA025703NIAAA NIH HHS R34 AA027983NIDA NIH HHS T32 DA007250
6 · The paper itself

Abstract

backgroundDepression disproportionately affects individuals in low- and middle-income countries (LMICs). Economic hardship and family strain exacerbate challenges, particularly for women. This study evaluated effects of Mlambe, an intervention targeting economic empowerment and relationship strengthening, on mental health in couples with HIV and unhealthy alcohol use in Malawi. This paper reports the secondary mental health outcomes.

methodsParticipants were 78 married couples (156 individuals) with HIV and unhealthy alcohol use (AUDIT-C; 84.4 % sero-concordant positive) from Zomba, Malawi-a district with rural and urban areas. A pilot RCT compared Mlambe (39 couples) to enhanced usual care (39 couples). Mlambe included ten monthly group and individual sessions delivered by trained staff on economic empowerment and relationship skills, with incentivized joint savings accounts matched by the study. Depression (Center for Epidemiologic Studies Depression Scale), stress (Perceived Stress Scale), and hopelessness (Beck Hopelessness Inventory) were assessed at baseline, 10, and 15 months. Linear mixed models tested for between-arm differences.

resultsResults demonstrated significant reductions in depression (Cohen's d = 0.41-0.46), stress (Cohens' d = 0.52-0.54), and hopelessness (Cohen's d = 0.26-0.29) in the Mlambe arm compared to control at 10- and 15-month follow-ups (p < .05). Mlambe had a larger effect on women's reports of stress and hopelessness as compared to men (p < .05), with 96 % study retention.

conclusionFindings underscore the potential of economic and relationship-focused interventions for improving mental health among people with HIV and unhealthy alcohol use in resource-limited settings. Economic empowerment approaches, particularly for women, may be effective in reducing hopelessness and stress.

Indexed as

DepressionHIV InfectionsHopeInterpersonal RelationsStress, PsychologicalAdultAlcoholismFemaleHumansMalawiMaleMiddle AgedPilot ProjectsAlcohol useCouples-based approachDepressionEconomic interventionHIVHopelessnessLow- and middle-income countriesSocial determinants of healthSocioeconomic status

Identifiers

PMID40914533
PMCPMC12714417

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

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.