A non-specialist depression care pathway for adolescents living with HIV and transitioning into adult care in Peru: a nested, proof of concept pilot study
Abstract Background Adolescents living with HIV (ALWH) are disproportionally impacted by depression, experiencing worse HIV outcomes. Integrated depression and HIV care may support antiretroviral adherence. This study pilot tested for proof of concept a basic depression care pathway for ALWH to info...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Cambridge University Press
2021-01-01
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| Series: | Cambridge Prisms: Global Mental Health |
| Subjects: | |
| Online Access: | https://www.cambridge.org/core/product/identifier/S2054425121000169/type/journal_article |
| _version_ | 1811156109812039680 |
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| author | Jerome T. Galea Carmen Contreras Milagros Wong Karen Ramos Valentina Vargas Hugo Sánchez Renato A. Errea Leonid Lecca Molly F. Franke |
| author_facet | Jerome T. Galea Carmen Contreras Milagros Wong Karen Ramos Valentina Vargas Hugo Sánchez Renato A. Errea Leonid Lecca Molly F. Franke |
| author_sort | Jerome T. Galea |
| collection | DOAJ |
| description | Abstract
Background
Adolescents living with HIV (ALWH) are disproportionally impacted by depression, experiencing worse HIV outcomes. Integrated depression and HIV care may support antiretroviral adherence. This study pilot tested for proof of concept a basic depression care pathway for ALWH to inform depression care integration with HIV services in Peru.
Methods
ALWH were screened for depression with the Patient Health Questionnaire-9 (PHQ-9). Participants with PHQ-9 scores of ⩾10 or suicidal ideation (SI) were eligible for Psychological First Aid (PFA) delivered by non-mental health specialists. Participants with PHQ-9 re-assessments of ⩾20 or SI were referred to specialized services.
Results
Twenty-eight (11 female, 17 male) ALWH aged 15–21 years participated; n = 20 (71%) identified as heterosexual. Most (18/28) acquired HIV at birth. Baseline PHQ-9 scores were 0–4, n = 3 (11%); 5–9, n = 9 (32%); 10–14, n = 10 (36%); 15–19, n = 4 (14%); and 20–27, n = 2 (7%). Eleven participants (40%) reported SI. Among participants with PHQ-9 > 4, 92% (23/25) were not severe. Of the 21 (75%) of participants eligible for PFA, n = 9 (32%) accepted at least one session, of which n = 3 (33%) were linked to specialized care.
Conclusions
A simple care pathway operationalizing depression screening and non-specialist delivered emotional support is a first step toward integrated depression and HIV care for ALWH.
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| first_indexed | 2024-04-10T04:44:57Z |
| format | Article |
| id | doaj.art-5f4a79f316b34ce3900ae8e6b22661d6 |
| institution | Directory Open Access Journal |
| issn | 2054-4251 |
| language | English |
| last_indexed | 2024-04-10T04:44:57Z |
| publishDate | 2021-01-01 |
| publisher | Cambridge University Press |
| record_format | Article |
| series | Cambridge Prisms: Global Mental Health |
| spelling | doaj.art-5f4a79f316b34ce3900ae8e6b22661d62023-03-09T12:35:45ZengCambridge University PressCambridge Prisms: Global Mental Health2054-42512021-01-01810.1017/gmh.2021.16A non-specialist depression care pathway for adolescents living with HIV and transitioning into adult care in Peru: a nested, proof of concept pilot studyJerome T. Galea0https://orcid.org/0000-0001-8732-6959Carmen Contreras1Milagros Wong2Karen Ramos3Valentina Vargas4Hugo Sánchez5Renato A. Errea6https://orcid.org/0000-0003-0656-0036Leonid Lecca7https://orcid.org/0000-0003-1363-3985Molly F. Franke8https://orcid.org/0000-0002-4890-5728School of Social Work, University of South Florida, Tampa, USA College of Public Health, University of South Florida, Tampa, USA Department of Global Health and Social Medicine, Harvard Medical School, Boston, USASocios En Salud, Lima, PeruSocios En Salud, Lima, PeruSocios En Salud, Lima, PeruHarvard School of Public Health, Boston, USAEpicentro, Lima, PeruDepartment of Global Health and Social Medicine, Harvard Medical School, Boston, USADepartment of Global Health and Social Medicine, Harvard Medical School, Boston, USA Socios En Salud, Lima, PeruDepartment of Global Health and Social Medicine, Harvard Medical School, Boston, USAAbstract Background Adolescents living with HIV (ALWH) are disproportionally impacted by depression, experiencing worse HIV outcomes. Integrated depression and HIV care may support antiretroviral adherence. This study pilot tested for proof of concept a basic depression care pathway for ALWH to inform depression care integration with HIV services in Peru. Methods ALWH were screened for depression with the Patient Health Questionnaire-9 (PHQ-9). Participants with PHQ-9 scores of ⩾10 or suicidal ideation (SI) were eligible for Psychological First Aid (PFA) delivered by non-mental health specialists. Participants with PHQ-9 re-assessments of ⩾20 or SI were referred to specialized services. Results Twenty-eight (11 female, 17 male) ALWH aged 15–21 years participated; n = 20 (71%) identified as heterosexual. Most (18/28) acquired HIV at birth. Baseline PHQ-9 scores were 0–4, n = 3 (11%); 5–9, n = 9 (32%); 10–14, n = 10 (36%); 15–19, n = 4 (14%); and 20–27, n = 2 (7%). Eleven participants (40%) reported SI. Among participants with PHQ-9 > 4, 92% (23/25) were not severe. Of the 21 (75%) of participants eligible for PFA, n = 9 (32%) accepted at least one session, of which n = 3 (33%) were linked to specialized care. Conclusions A simple care pathway operationalizing depression screening and non-specialist delivered emotional support is a first step toward integrated depression and HIV care for ALWH. https://www.cambridge.org/core/product/identifier/S2054425121000169/type/journal_articleAdolescentsdepressionintegrated carePeru |
| spellingShingle | Jerome T. Galea Carmen Contreras Milagros Wong Karen Ramos Valentina Vargas Hugo Sánchez Renato A. Errea Leonid Lecca Molly F. Franke A non-specialist depression care pathway for adolescents living with HIV and transitioning into adult care in Peru: a nested, proof of concept pilot study Cambridge Prisms: Global Mental Health Adolescents depression integrated care Peru |
| title | A non-specialist depression care pathway for adolescents living with HIV and transitioning into adult care in Peru: a nested, proof of concept pilot study |
| title_full | A non-specialist depression care pathway for adolescents living with HIV and transitioning into adult care in Peru: a nested, proof of concept pilot study |
| title_fullStr | A non-specialist depression care pathway for adolescents living with HIV and transitioning into adult care in Peru: a nested, proof of concept pilot study |
| title_full_unstemmed | A non-specialist depression care pathway for adolescents living with HIV and transitioning into adult care in Peru: a nested, proof of concept pilot study |
| title_short | A non-specialist depression care pathway for adolescents living with HIV and transitioning into adult care in Peru: a nested, proof of concept pilot study |
| title_sort | non specialist depression care pathway for adolescents living with hiv and transitioning into adult care in peru a nested proof of concept pilot study |
| topic | Adolescents depression integrated care Peru |
| url | https://www.cambridge.org/core/product/identifier/S2054425121000169/type/journal_article |
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