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Integrating Depression Care Into HIV Services for Older People With HIV Using a Stepped Care, Task-Sharing Approach.
Sponsor: Royal Society of Tropical Medicine and Hygiene
Summary
Depression levels will be compared using PHQ-9 in the Treatment as Usual arm(TAU) VS intervention arm to see if the stepped care intervention is effective in treating depression. The main questions it aims to answer are: * Needs assessment of stepped-care integration versus usual care for treating depression in older adults living with HIV? * How effective will the stepped care task-sharing (SCT) model in reducing depressive symptoms and improving HIV treatment outcomes in older PLHIV in Nigeria? Participants who screen positive for depression PHQ-9 ≥10 will be randomized into 2 arms for treatment using a systemized ballot system: TAU arm and Intervention arm. TAU arm will receive current treatment available for depression at the HIV center. Intervention arm will receive the stepped-care intervention in stages based on their symptom severity. Follow-up assessments at (6 weeks, 3months and 6 months) will be conducted by assessors who would be blinded to the different groups (TAU arm VS intervention arm).
Official title: The Adaptation of a Stepped Care, Task-sharing Approach for Integrating Depression Care for Older People Living With HIV (PLHIV) Into HIV Treatment and Support Services in Ibadan, Nigeria.
Key Details
Gender
All
Age Range
50 Years - 100 Years
Study Type
INTERVENTIONAL
Enrollment
120
Start Date
2025-03-24
Completion Date
2026-03-24
Last Updated
2025-07-22
Healthy Volunteers
No
Conditions
Interventions
Stepped care
It is a systematic, staged approach to delivering care based on the severity of a condition and the patient's response to treatment. In this model, less intensive interventions are provided first, and only those who do not improve progress to more intensive treatments. In clinical research, stepped-care is classified as an adaptive intervention, where treatment is adjusted based on pre-specified criteria, making it patient-centered and resource-efficient.
Treatment as usual
Clients that are considered to be depressed are offered counselling by the Nurses who are the first point of contact. Depending on the severity of symptoms the client are then referred to the medical officer at the HIV clinic for assessment and offered counselling services by the counsellors. if symptoms are severe and considered to need specialist care the medical officer will refer to a specialist(psychiatrist) outside the HIV care facility.
Locations (1)
Institute of Infectious Diseases
Ibadan, Oyo State, Nigeria