Transdiagnostic psychological intervention (CETA) improves three-month HIV retention by over 14% in Mozambique

Abstract

Common mental disorders (CMDs) are associated with poor HIV outcomes in low- and middle-income countries, yet few have scaled-up CMD treatments in HIV platforms. The present study analyzed a demonstration project of a psychological therapy delivered in routine HIV care and its effects on HIV outcomes in Mozambique. In May 2019, the Common Elements Treatment Approach (CETA) was integrated into routine HIV care in five facilities in Sofala, Mozambique. All newly-diagnosed adult HIV+ patients were screened for CMDs and those with clinically-significant symptoms were offered CETA. CETA HIV treatment initiation and retention were compared to overall facility averages. Of 250 patients screened, 59.2% (148/250) showed clinically significant CMD symptoms and 92.6% (137/148) enrolled in CETA. 10.2% of enrolled (14/137) had current suicidal ideation. After four CETA visits, CMD symptoms decreased >50% and suicidal ideation decreased 100%. Patients enrolling in CETA had an ART initiation rate of 97.1% (133/137), one-month retention of 69.2% (89/129), and three-month retention of 82.4% (89/108). Overall facility retention averages were 66.0% at one month and 68.0% at three months. Four sessions of CETA decreased CMD symptoms by >50% and suicidal ideation by 100%. CETA patients had 14.4% higher absolute three-month retention versus overall facility averages. CETA is a promising approach to reduce symptoms of CMDs and improve HIV care cascade outcomes in areas with high HIV prevalence