Evaluation of the impact of a depression treatment program on mental health and HIV care outcomes in Malawi

The study employed a pre-post multiple baseline design in two public health clinics in urban Lilongwe. During the screening (“pre“) phase, depression screening was integrated into ART initiation and providers were re-oriented to existing depression treatment options. During the active (“post“) phase, providers were additionally trained in algorithm-guided antidepressant prescription for moderate to severe depression, and lay health workers were trained in Friendship Bench problem-solving therapy for mild depression. All patients starting ART were followed forward until six months after ART initiation for HIV appointment attendance, viral load, and depressive symptom outcomes. Data were collected from clinical records on HIV appointment attendance, viral suppression, and depressive symptoms during the first six months after ART initiation.