Evidence-based mental health assessment and treatment for HIV prevention in Kenya

描述（由申请人提供）：精神障碍通常与艾滋病毒/艾滋病同时发生，但在肯尼亚仍未得到诊断和治疗。这些疾病与药物依从性差、危险性行为以及最终艾滋病毒/艾滋病的持续传播有关。因此，迫切需要有效评估和治疗精神障碍，如严重抑郁症和酗酒障碍，特别是艾滋病毒/艾滋病感染者或有感染风险的人。虽然在有效评估和治疗精神和酒精使用障碍方面取得了重大进展，但在肯尼亚等发展中国家，这些循证方法往往没有加以调整和试验。这一国际研究科学家发展奖的广泛目标是通过一种文化上适当和可持续的转化方法，促进对精神和酒精使用障碍的循证评估和治疗。该研究计划的具体目的是：1)评估艾滋病毒/艾滋病感染者和在肯尼亚内罗毕贫民窟社区的一家健康诊所接受艾滋病毒检测的成年人中精神疾病和酒精使用障碍的患病率；2)实施和评估针对这些成年人的文化相关的、可持续的精神健康转诊和酒精使用障碍干预方案的可行性和可接受性。候选人将对所有评估工具和将要实施的干预计划的心理测量特性进行定性和定量测试。受监督的临床心理学硕士生将被用于这种可持续的治疗模式。这项研究的长期目标是帮助建设肯尼亚贫困地区初级保健诊所的能力，使它们能够促进对所有病人的精神保健，特别是对越来越多的酗酒障碍患者的精神保健。候选人建议在与美国和肯尼亚的精神健康评估和治疗专家进行密切指导培训期间实施该研究计划。拟议对候选人进行的有指导的培训将使她能够作为一名国际精神卫生流行病学家向独立过渡。

DESCRIPTION (provided by applicant): Mental disorders often co-occur with HIV/AIDS, yet continue to be left undiagnosed and untreated in Kenya. These disorders are associated with poor medication adherence, risky sexual behavior, and ultimately the continued spread of HIV/AIDS. Therefore, there is a critical need for effective assessment and treatment of mental disorders such as major depression and alcohol use disorders particularly among people living with or at risk for HIV/AIDS. Although major advances in the effective assessment and treatment of psychiatric and alcohol use disorders have been made, these evidence-based methods are often not adapted and tested in developing countries such as Kenya. The broad objective of this International Research Scientist Development Award (IRSDA) is to promote evidence-based assessment and treatment of psychiatric and alcohol use disorders through a translational approach that is both culturally appropriate and sustainable. The specific aims of the research plan are to 1) Assess the prevalence of psychiatric and alcohol use disorders among adults living with HIV/AIDS and adults being tested for HIV at a health clinic located in a slum community of Nairobi, Kenya, and 2) Implement and evaluate the feasibility and acceptability of a culturally relevant, sustainable, mental health referral and alcohol use disorder intervention program for these adults. The candidate will conduct both qualitative and quantitative tests of the psychometric properties of all assessment tools and intervention programs to be implemented. Supervised clinical psychology Masters students will be used for this sustainable treatment model. The long-term objectives of this research are to help build the capacity of primary care health clinics in underprivileged areas of Kenya such that they are able to promote mental health care for all their patients and particularly the growing number with alcohol use disorders. The candidate proposes to implement this research plan during a period of close mentored training with experts in mental health assessment and treatment in both the United States and Kenya. The proposed mentored training for the candidate will enable her transition towards independence as an international mental health epidemiologist. PUBLIC HEALTH RELEVANCE: The proposed mental health research among people living with or at risk for HIV/AIDS in Kenya will directly benefit the health of the adults in the study as well as help train Kenyan mental health clinicians in evidence- based assessment and treatment of psychiatric and alcohol use disorders. The public health significance of this research is centered upon building capacity to treat mental disorders in Kenya effectively as well as aid in prevention efforts to decrease the spread of HIV/AIDS.