Vavani Boitumelo, Garnefski Nadia, van Luenen Sanne, Dusseldorp Elise, Amone-P'Olak Kennedy, Spinhoven Philip, Kraaij Vivian
University of Botswana, Gaborone, Botswana.
Clinical Psychology, Leiden University, Leiden, The Netherlands.
AIDS Behav. 2025 Apr 29. doi: 10.1007/s10461-025-04742-7.
In low- and middle-income countries (LMICs), there is a scarcity of psychological treatment options for people living with HIV (PLWH) with depressive symptoms. Self-help programs for depressive symptoms, in particular, are cost-effective and scalable, and therefore a promising tool in the treatment of depressive symptoms for people in low-resourced countries. This paper presents the results of a study that examined the effectiveness of a guided self-help program in reducing depressive symptoms in PLWH in Botswana. A Randomized Controlled Trial (RCT) was conducted on a sample of PLWH who were screened at HIV treatment centers in Botswana. The RCT had two conditions: an intervention group that received the self-help program with coaching and an attention-only control group. In both groups, a pre-test, post-test, and 3-month follow-up measurement were administered. Patients in the intervention group followed a booklet Cognitive Behavioral Therapy (CBT)-based self-help program. Seventy-two participants were included in the study. The results indicated significantly larger decreases in depressive symptoms in the intervention group than in the attention-only control group, both in the short and longer term, with large effect sizes. In addition, there were significant reductions in anxiety symptoms in the intervention group compared to the control group. The user satisfaction was high. Implementing this low-cost and scalable self-help program in a LMIC such as Botswana is critical in bridging the existing mental health treatment gap. This clinical Trial was registered with the Netherlands Trial registry, number NTR5407on August 23, 2018.
在低收入和中等收入国家（LMICs），感染艾滋病毒（PLWH）且有抑郁症状的人群缺乏心理治疗选择。尤其是针对抑郁症状的自助项目，具有成本效益且可扩展，因此是资源匮乏国家治疗抑郁症状的一种有前景的工具。本文介绍了一项研究的结果，该研究考察了一个引导式自助项目在减轻博茨瓦纳感染艾滋病毒者抑郁症状方面的有效性。对在博茨瓦纳艾滋病毒治疗中心接受筛查的感染艾滋病毒者样本进行了随机对照试验（RCT）。该随机对照试验有两个条件：一个是接受带辅导的自助项目的干预组，另一个是仅接受关注的对照组。两组都进行了预测试、后测试和3个月的随访测量。干预组的患者遵循基于认知行为疗法（CBT）的自助手册项目。72名参与者被纳入研究。结果表明，干预组在短期和长期内抑郁症状的减轻幅度均显著大于仅接受关注的对照组，效应量较大。此外，与对照组相比，干预组的焦虑症状也有显著减轻。用户满意度较高。在博茨瓦纳这样的低收入和中等收入国家实施这种低成本且可扩展的自助项目，对于弥合现有的心理健康治疗差距至关重要。该临床试验于2018年8月23日在荷兰试验注册中心注册，注册号为NTR5407。
