Integrating depression management in HIV care in Uganda

Conditions

Depressive disorders in HIV/AIDS Mental and Behavioural Disorders

Kinyanda E, Kyohangirwe L, Mpango RS, Sekitoleko I, Ssembajjwe W, Tusiime C, Ssebunnya J, Katumba K, Kiconco BE, Laurence Y, Tenya P, Turyahabwa J, Katana P, Ross I, Vassall A, Greco G, Mugisha J, Taasi G, Sentongo H, Akena D, Muhwezi WW, Weiss HA, Neuman M, Knizek BL, Levin J, Kaleebu P, Araya R, Patel V.

2026-01-15

10.1016/s2352-3018(25)00232-2

Effectiveness and cost-effectiveness of integrating the management of depression into routine HIV Care in Uganda (the HIV + D trial): A protocol for a cluster-randomised trial.

Kinyanda E, Kyohangirwe L, Mpango RS, Tusiime C, Ssebunnya J, Katumba K, Tenywa P, Mugisha J, Taasi G, Sentongo H, Akena D, Laurence Y, Muhwezi W, Weiss HA, Neuman M, Greco G, Knizek B, Levin J, Kaleebu P, Araya R, Ssembajjwe W, Patel V.

2021-05-125 citations

10.1186/s13033-021-00469-9

Interventions

This project will be organised under two broad phases: Formative phase: During this phase the HIV+D intervention will be developed. To do this, the MANAS intervention (which is a stepped care collabo

Eligibility

Sex/Gender

All

Age

18 Years to 100 Years

Inclusion criteria

Inclusion criteria: 1. Adult patients living with HIV attending the study clinics 2. Aged >18 years 3. An established resident of the study area 4. Medically stable (not too ill to require emergency admission) 5. Conversant in Luganda (the predominant language spoken in the study area) 6. ‘Screen positive’ for a depressive disorder (DD) (a score of =10 on the PHQ-9)

Exclusion criteria

Exclusion criteria: 1. Adults who screen below the DD threshold score on the PHQ-9 2. Those who have severe cognitive or sensory impairments which hinder engagement with the research procedures

Design outcomes

Primary

Measure	Time frame
1. Mean depressive disorder (DD) symptom severity scores, assessed using the PHQ-9 at 6 months 2. Proportion of participants who fail to achieve remission from DD; proportion with PHQ-9 scores =5 at 6 months	—

Secondary

Measure	Time frame
1. The primary outcome measures at 12 months 2. The proportion of participants who are on ART at baseline and who have virological failure (defined as a viral load of 1,000 copies/ML or more) at 6 and 12 months 3. The proportion of participants who report having missed at least one dose of cotrimoxazole prophylaxis in the past three days, assessed at 6 and 12 months 4. The mean CD4 count at 6 and 12 months 5. The proportion of participants who experience either a new WHO stage 3 or 4 event or death over the 12 months 6. Quality adjusted life years (QALYs), measured using the SF-6D (the Short-Form Six-Dimension) at quarterly intervals for 12 months 7. Days out of work and functional impairment, measured using the WHO-DAS29 at 6 and 12 months 8. Failure to recover from DD; proportion whose PHQ-9 scores are =5 on two consecutive occasions 3 months apart and who relapse after recovery	—

Measure

Time frame

1. The primary outcome measures at 12 months 2. The proportion of participants who are on ART at baseline and who have virological failure (defined as a viral load of 1,000 copies/ML or more) at 6 and 12 months 3. The proportion of participants who report having missed at least one dose of cotrimoxazole prophylaxis in the past three days, assessed at 6 and 12 months 4. The mean CD4 count at 6 and 12 months 5. The proportion of participants who experience either a new WHO stage 3 or 4 event or death over the 12 months 6. Quality adjusted life years (QALYs), measured using the SF-6D (the Short-Form Six-Dimension) at quarterly intervals for 12 months 7. Days out of work and functional impairment, measured using the WHO-DAS29 at 6 and 12 months 8. Failure to recover from DD; proportion whose PHQ-9 scores are =5 on two consecutive occasions 3 months apart and who relapse after recovery

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Countries

Uganda

Outcome results

None listed