Improving Mental and Behavioral Health in Sub-Saharan Africa
About
Our research focuses on improving the mental health and health-related behaviors of people living with HIV and other vulnerable groups in global, low-resource settings. We use mixed methods to understand the individual and social factors associated with better health outcomes. Our ultimate goal is to develop, test, and disseminate culturally-appropriate behavioral interventions in innovative and sustainable ways.
Team
The project leader of this research is Dr. Jennifer Belus. You can read more about Dr. Belus and team members below. Their research is part of the International HIV and Chronic Care Disease Group, headed by Prof. Niklaus Labhardt.
Jennifer Belus has a PhD in Clinical Psychology from the University of North Carolina. The focus of her work is on understanding and shifting the social environment to advance interventions for mental health, HIV health behaviors, and improving the HIV care continuum.
Fabian Räber completed his bachelor degree at ETH Zurich and is continuing his master studies in Medicine at the University of Basel. He is currently working on his master thesis focused on community-based care for mental health disorders in sub-Saharan Africa and has a strong interest in public health.
Maria-Inés Haldemann is a Master student in Medicine at the University of Basel. She is completing her Master's thesis focusing on community-based care for mental health problems in sub-Saharan Africa.
Michelle Harder is a medical student in the 3rd year of her Bachelor degree at the University of Basel. She will complete her Masters thesis using qualitative data to understand the mental health care needs of people living with HIV in Lesotho.
Studies
- Testing a couple-based intervention for mental health in Lesotho. The World Health Organization (WHO) developed the Mental Health Gap Action Programme (mhGAP), a training and intervention guide for non-specialist providers to deliver evidence-based treatment for mental health problems, including depression and substance use. This study will assess whether an adapted version of mhGAP, which includes a loved one in treatment alongside the patient, is more effective at improving depression and substance use in people living with HIV in Lesotho, than the existing standard of care. This study is conducted in collaboration with SolidarMed Lesotho and is funded by the Swiss National Science Foundation (PI: Belus).
- Masculinity, HIV disclosure, and HIV care engagement. Engaging men throughout the HIV care cascade is an ongoing challenge and one of the biggest barriers to reaching UNAIDS’ 95-95-95 goals to end the HIV epidemic. Idealized forms of masculinity may impede men’s ART initiation and retention in care through non-disclosure of HIV status. This study will test whether men living with HIV in Cape Town who hold unhelpful idealized beliefs about masculinity have more difficulty disclosing their HIV status, and in turn, are less likely to be retained in HIV care over a period of 6 months. This study is conducted in collaboration with the University of Cape Town and the University of Maryland and is funded by the National Institute of Mental Health (R21MH123280; MPIs: Belus, Marais, Magidson).
- Pilot-testing a couple-based intervention for women’s ART adherence. Supporting Treatment for Anti-Retroviral Therapy (START) Together is a behavioral intervention based in cognitive-behavioral couple therapy, wherein couples learn communication and problem-solving skills to address ART adherence and enhance their relationship. This study pilot tests START Together versus standard of care (referral to the local clinic for ART adherence counseling) in order to improve ART adherence in women living with HOV on KwaZulu-Natal, South Africa. The study is conducted in collaboration with the Human Sciences Research Council and funded by the Canadian Institutes of Health Research (PI: Belus).
- Mental health stigma reduction intervention for community health workers (CHWs). Re-engaging people living with HIV and TB back into care is an ongoing challenge in South Africa. CHWs are a non-specialist cadre of providers whose primary task is to make home visits to patients and re-engage them back into care. However, CHW stigma towards depression and substance use may hinder their ability to successfully re-engage patients who are struggling with retention in care. This study will pilot test an intervention designed to reduce CHW stigma towards depression and substance use in Cape Town and test whether such an intervention can help CHWs more effectively engage patients back into care. This study is conducted in collaboration with the South African Medical Research Council (SAMRC) and funded by the National Institute of Mental Health (R34MH122268; MPIs: Magidson & Myers).
- Mental health burden in clinic and community settings in Lesotho. To date, there is very limited data on the mental health burden in Lesotho. To remedy this, we are collecting data on rates of depression, anxiety, trauma, and substance use in people living with HIV in clinic settings and in the general population (both adolescents and adults). This data will guide future intervention work to target the highest burden mental health problems.
Collaborators
Dr. Jessica Magidson and the Global Mental Health and Addiction Program (GMAP) at the University of Maryland, in the US.
Dr. Adele Marais and the HIV Mental Health Research Unit at the University of Cape Town, in South Africa.
Dr. Bronwyn Myers and Dr. Tara Carney and the Alcohol, Tobacco, and Other Drugs Research Unit at the South African Medical Research Council (SAMRC) in Cape Town, South Africa.
Dr. Alastair van Heerden and the Human Sciences Research Council (HSRC) in Pietermaritzburg, South Africa.
SolidarMed Lesotho, a Swiss NGO that promotes sustainable healthcare projects in primarily rural settings. Collaborators include Chejane Ntoiseng, Mpho Kao, and Palesa Mahlatsi.
