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From surviving to thriving: integrating mental health care into HIV, community, and family services for adolescents living with HIV.
Cluver, Lucie D; Sherr, Lorraine; Toska, Elona; Zhou, Siyanai; Mellins, Claude-Ann; Omigbodun, Olayinka; Li, Xiaoming; Bojo, Samuel; Thurman, Tonya; Ameyan, Wole; Desmond, Chris; Willis, Nicola; Laurenzi, Christina; Nombewu, Amahle; Tomlinson, Mark; Myeketsi, Noxolo.
  • Cluver LD; Department of Social Policy and Intervention, University of Oxford, Oxford, UK; Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa. Electronic address: lucie.cluver@spi.ox.ac.uk.
  • Sherr L; Institute of Global Health, University College London, London, UK.
  • Toska E; Department of Social Policy and Intervention, University of Oxford, Oxford, UK; Centre for Social Science Research, University of Cape Town, Cape Town, South Africa.
  • Zhou S; Centre for Social Science Research, University of Cape Town, Cape Town, South Africa; School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa.
  • Mellins CA; HIV Center for Clinical and Behavioral Studies, Department of Psychiatry, New York State Psychiatric Institute, New York, NY, USA; Columbia University Irving Medical Center, New York, NY, USA.
  • Omigbodun O; Department of Psychiatry, College of Medicine, University of Ibadan, Ibadan, Nigeria.
  • Li X; Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA.
  • Bojo S; Agency for Research and Development Initiative, Juba, South Sudan.
  • Thurman T; Highly Vulnerable Children Research Center, Cape Town, South Africa; Tulane University School of Public Health, New Orleans, LA, USA.
  • Ameyan W; Global HIV, Hepatitis and Sexually Transmitted Infections Programmes, World Health Organization, Geneva, Switzerland.
  • Desmond C; Centre for Rural Health, University of KwaZulu-Natal, Durban, South Africa.
  • Willis N; Africaid, Harare, Zimbabwe.
  • Laurenzi C; Institute for Life Course Health Research, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg, South Africa.
  • Nombewu A; Teen Advisory Group, University of Cape Town, Cape Town, South Africa.
  • Tomlinson M; Institute for Life Course Health Research, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg, South Africa; School of Nursing and Midwifery, Queens University, Belfast, UK.
  • Myeketsi N; Department of Information Systems, University of the Western Cape, Cape Town, South Africa.
Lancet Child Adolesc Health ; 6(8): 582-592, 2022 08.
Article in English | MEDLINE | ID: covidwho-1972409
ABSTRACT
Adolescents are a crucial generation, with the potential to bring future social and economic success for themselves and their countries. More than 90% of adolescents living with HIV reside in sub-Saharan Africa, where their mental health is set against a background of poverty, familial stress, service gaps, and an HIV epidemic that is now intertwined with the COVID-19 pandemic. In this Series paper, we review systematic reviews, randomised trials, and cohort studies of adolescents living with and affected by HIV. We provide a detailed overview of mental health provision and collate evidence for future approaches. We find that the mental health burden for adolescents living with HIV is high, contributing to low quality of life and challenges with adherence to antiretroviral therapy. Mental health provision is scarce, infrastructure and skilled providers are missing, and leadership is needed. Evidence of effective interventions is emerging, including specific provisions for mental health (eg, cognitive behavioural therapy, problem-solving, mindfulness, and parenting programmes) and broader provisions to prevent drivers of poor mental health (eg, social protection and violence prevention). We provide evidence of longitudinal associations between unconditional government grants and improved mental health. Combinations of economic and social interventions (known as cash plus care) could increase mental health benefits. Scalable delivery models include task sharing, primary care integration, strengthening families, and a pyramid of provision that differentiates between levels of need, from prevention to the care of severe disorders. A turning point has now been reached, from which complacency cannot persist. We conclude that there is substantial need, available frameworks, and a growing evidence base for action while infrastructure and skill acquisition is built.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: HIV Infections / COVID-19 Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study / Randomized controlled trials / Reviews / Systematic review/Meta Analysis Limits: Adolescent / Humans Language: English Journal: Lancet Child Adolesc Health Year: 2022 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Main subject: HIV Infections / COVID-19 Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study / Randomized controlled trials / Reviews / Systematic review/Meta Analysis Limits: Adolescent / Humans Language: English Journal: Lancet Child Adolesc Health Year: 2022 Document Type: Article