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

描述（由申请人提供）：精神障碍经常与艾滋病毒/艾滋病同时发生，但在肯尼亚仍然没有得到诊断和治疗。这些疾病与药物依从性差、危险的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疾病和酒精使用障碍方面取得了重大进展，但这些循证方法往往没有在肯尼亚等发展中国家得到调整和检验。该国际研究科学家发展奖（IRSDA）的广泛目标是通过文化上适当和可持续的转化方法，促进对精神病和酒精使用障碍的循证评估和治疗。该研究计划的具体目标是：1）评估成年艾滋病毒/艾滋病感染者和正在肯尼亚内罗毕贫民窟社区卫生诊所接受艾滋病毒检测的成年人中精神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、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干预计划的心理测量特性进行定性和定量测试。监督临床心理学硕士生将用于这种可持续的治疗模式。这项研究的长期目标是帮助肯尼亚贫困地区初级保健诊所的能力建设，使他们能够促进所有患者的心理健康护理，特别是越来越多的酒精使用障碍患者。候选人建议在美国和肯尼亚的心理健康评估和治疗专家的密切指导培训期间实施这项研究计划。拟议的候选人辅导培训将使她能够过渡到独立作为一个国际精神卫生流行病学家。 公共卫生相关性：拟议的肯尼亚艾滋病毒/艾滋病感染者或高危人群心理健康研究将直接有益于研究中成年人的健康，并有助于培训肯尼亚心理健康临床医生对精神病和酒精使用障碍进行循证评估和治疗。这项研究的公共卫生意义集中在建设能力，以有效地治疗肯尼亚的精神障碍，以及在预防工作，以减少艾滋病毒/艾滋病的传播援助。

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.