Effectiveness of Community-Based Peer-Facilitated Psychological and Social Support Interventions on Improving Mental Health in Cameroonian Adolescents With Perinatal HIV: The IAS-CIPHER-2021/1214-ATE SMAVI Controlled Randomized Trial (November 2021−May 2023)

Abstract

BACKGROUND: Psychological and social support to adolescents living with HIV remains undocumented and unaddressed in Central Africa. This study aimed to assess effectiveness of a peer-facilitated community-based support in improving mental health among Cameroonian adolescents living with vertically acquired HIV (ALHIV). SETTING: The study was conducted in a national referral hospital in Yaounde, Cameroon. METHODS: This was a parallel randomized controlled trial in ALHIV. The control arm only received routine support in the health facility; the intervention arm benefited from community-based and peer-facilitated support. The endpoints were mean mental health scores' variations from month 0 to month 15, estimated based on validated French versions mental health scales and using independent samples' Student t test. RESULTS: In total, 305 ALHIV were recruited at a mean age of 15.0 years old, including 162 (53.1%) females,153 individuals in the intervention arm; in whom symptoms of severe depression (26.9%), high or very high anxiety (28.9%), and low self-esteem (84.9%). From month 0 to month 15, there was increase in self-esteem (mean between-arm difference (M) (standard deviation (SD))=+0.5 (SD: 1.0) ;; significance degree (p)= 0.6543), decrease in symptoms of depression (M=-0.2 (SD: 1.4);; p= 0.9098) and decrease in symptoms of anxiety (M=-1.8 (SD: 3.4);; p= 0.7338), without significant differences between the 2 arms. CONCLUSIONS: This study showed benefits in anxiety and depression reduction and improvement in self-esteem in both arms, without any significant difference, suggesting that regardless of whether psychosocial interventions are implemented in-clinic or in the community, both are of benefit to patients.