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

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PROJECT SUMMARY (See instructions): 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.