The Mental Health HIV and Domestic Violence (MIND) study focused on gender-based violence and HIV outcomes during tracking and treatment of mental illness. The MIND study took place between 2015 and 2018.

MIND Study Background

Globally, HIV is the leading cause of death for reproductive-age women, and mental disorders are the leading causes of health disability for reproductive-age women in low- and middle-income countries (LMICs). HIV+ women suffer an especially high prevalence of mental disorders, due in part to gender-based violence (GBV) against HIV+ women (HIV+GBV+). Mental disorders affect most GBV survivors, typically manifesting as depression and post-traumatic stress disorder (PTSD). This problem is particularly acute in Sub-Saharan Africa, where the world’s majority of HIV+ women live and where the lifetime prevalence of GBV is high, ranging from 56 percent to 71 percent.

Compounding the issue is the fact that Sub-Saharan countries, similar to LMICs as a whole, have a dearth of mental health treatment services: An estimated 75 percent of those with serious mental disorders such as depression or PTSD never receive any treatment at all.

MIND Study Design

The MIND) study tested a scalable, sustainable strategy for treating depression and trauma-related disorders among HIV+ women affected by GBV in western Kenya, integrating care within an HIV clinic.

We conducted a randomized, controlled, hybrid-effectiveness type I trial of an established treatment for depression and PTSD called interpersonal psychotherapy (IPT), building on prior studies showing that community therapists can be trained to effectively deliver IPT for depression in Sub-Saharan Africa.  The study protocol has been published. 

MIND Study Results

Our preliminary data analyses show that, relative to controls, the majority of those who received IPT experienced:

  • Decreased symptoms of depression and PTSD
  • Complete and sustained remission of disease (depression and PTSD)
  • Decreased disability and work absenteeism, sustained across follow up

Findings are published in PlosMedicine.

Case Study

We describe a case in which local personnel without prior mental health training delivered IPT for the treatment of depression and posttraumatic stress disorder in an HIV+ woman who reported experiencing gender-based violence and was enrolled in HIV care at the Family AIDS, Care, Education and Services program in Kisumu, Kenya. This IPT case illustrates many of the common stressors faced by HIV+ women in East Africa, including both depressive and trauma-related sequela. With this 12-session course of IPT, led by a community therapist with no prior IPT training, both depression and PTSD were in full remission by the end of treatment. This case is illustrative of the many recent successes achieved by training nonspecialists to deliver structured psychotherapies in LMICs.

Read the case study