Background

Adolescents in Sub-Saharan Africa face a serious challenge with HIV, and many also struggle with depression. This can make it hard for them to stay engaged in their HIV care. We are testing two versions of the Friendship Bench program in Malawi to see if they can help reduce depression and improve care for young people living with HIV.

Study Design

We will have three groups of participants:

Group 1: Adapted Friendship Bench intervention (AFB, 35 participants)
Group 2: Enhanced Friendship Bench intervention with peer support (EFB, 35 participants)
Group 3: Standard care (SOC, 35 participants)

Participants will be young people aged 13-19 who are living with HIV and have signs of depression. They will be recruited from four clinics in Malawi starting in early 2024.

Interventions

The AFB includes six counseling sessions led by trained young counselors. The EFB adds peer support group sessions to help participants stay engaged in their HIV care. The standard care includes basic counseling and referrals for more serious mental health issues.

Outcomes

We will measure:

Feasibility: Can we successfully implement these interventions?
Acceptability: Do participants find these interventions helpful?
Fidelity: Are the interventions being delivered as planned?

We will also look at how well the interventions reduce depression and improve HIV health outcomes over six and twelve months.

Discussion

This pilot study aims to adapt the Friendship Bench model for young people living with HIV in Malawi. We hope to learn how adding peer support can help them stay engaged in their care. The results will guide future larger studies to further improve mental health and HIV care for adolescents.

Next Steps

We will define clear goals and measurable outcomes for the Friendship Bench interventions. We will also explore AI tools that can support these clinical needs and implement the project step by step, tracking results to understand the real-world impact.