Effectiveness and cost-effectiveness of group support psychotherapy delivered by trained lay health workers for depression treatment among people with HIV in Uganda: a cluster-randomised trial
Open accessAbstract
Background WHO recommends the use of psychological interventions as first-line treatment for depression in low-income and middle-income countries. However, evaluations of the effectiveness and cost-effectiveness of such interventions among people with HIV are scarce. Our aim was to establish the effectiveness of group support psychotherapy (GSP) delivered by lay health workers for depression treatment among people living with HIV in a rural area of Uganda on a large scale. Methods In this cluster-randomised trial, we included 30 health centres offering HIV care. These were randomly assigned to deliver either GSP or group HIV education (GHE). Randomisation, in a ratio of 1:1, was achieved by health centre managers separately picking a paper containing the intervention allocation from a basket. Participants were people living with HIV, aged 19 years and older, with mild to moderate major depression assessed with the Mini International Neuropsychiatric Interview depression module, taking antiretroviral therapy, and antidepressant-naive. Group sessions were led by trained lay health workers once a week for 8 weeks. The primary outcomes were the proportion of participants with major depression and function scores at 6 months post-treatment, analysed by intention to treat by means of multilevel random effect regression analyses adjusting for clustering in health centres. This trial is registered with the Pan African Clinical Trials Registry, PACTR201608001738234. Findings Between S…
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Brief lay-delivered therapy for treatment of depression in young people living with HIV in Uganda is also highly cost-effective at $13 per DALY averted.
“Brief lay-delivered therapy for treatment of depression in young people living with HIV in Uganda is also highly cost-effective at $13 per DALY averted. 452”
From The Lancet Psychiatry Commission on youth mental health (2024) · cites this paper as [452]
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- Authors
- Nakimuli-Mpungu, E., Musisi, S., Wamala, K., Okello, J., Ndyanabangi, S., Birungi, J., Nanfuka, M., Etukoit, M., Mayora, C., Ssengooba, F., Mojtabai, R., Nachega, J. B., Harari, O., & Mills, E. J.
- Affiliations
- Makerere University (UG)
- Gulu University (UG)
- Ministry of Health (UG)
- The AIDS Support Organization (UG)
- Johns Hopkins University (US)
- McMaster University (CA)
- ORCID
- Venue
- The Lancet Global Health
- Publisher
- Elsevier BV
- Published
- 2020-03
- Volume
- 8
- Issue
- 3
- Pages
- e387-e398
- ISSN
- 2214-109X (ISSN-L)
- OpenAlex
- W3004448407
- Cited by
- 106
- References
- 9
- Citations by year
- 2026: 14 · 2025: 18 · 2024: 23 · 2023: 25 · 2022: 10 · 2021: 11 · 2020: 5
- FWCI
- 13.93
- Type
- journal article
- Language
- en
- Update notices
- erratum (2020-08-01)
- Open access
- gold
- doi.org
- Licence
- Locations
- The Lancet Global Health (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- OSF Preprints (OSF Preprints) (submittedVersion, cc-by-nc)
- Open Science Framework
- Funders
- Grand Challenges Canada (0770-05)
- Topics
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Health Sciences › Medicine › Infectious Diseases › HIV/AIDS Research and Interventions
- Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
- Keywords
- depression treatment, people living with HIV, lay health workers, community-based mental health interventions, cost-effectiveness, functional capacity, rural health facilities, Uganda, low- and middle-income countries, serious adverse events
- MeSH terms
- Adult, Community Health Workers, Cost-Benefit Analysis, Depression, Female, Humans, Male, Middle Aged, Psychotherapy, Group, Rural Population, Social Support, Uganda, HIV Infections, Treatment Outcome
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