The role of depression screening and treatment in achieving the UNAIDS 90–90–90 goals in sub-Saharan Africa
Kazione Kulisewa, Melissa A. Stockton, Mina C. Hosseinipour, Bradley N. Gaynes, Steve Mphonda, Michael M. Udedi, and Brian W. Pence
2019. AIDS and Behavior. Online ahead of print, 17 July
Despite widespread HIV screening and treatment programs across sub-Saharan Africa, many countries are not on course to meet the Joint United Nations Program on HIV/AIDS 90–90–90 targets. As mental health disorders such as depression are prevalent among people living with HIV, investment in understanding and addressing comorbid depression is increasing. This manuscript aims to assess depression and HIV management in sub-Saharan Africa using a 90–90–90 lens through a discussion of: depression and the HIV care continuum; the state of depression screening and treatment; and innovations such as task-shifting strategies for depression management. Due to the lack of mental health infrastructure and human resources, task-shifting approaches that integrate mental health management into existing primary and community health programs are increasingly being piloted and adopted across the region. Greater integration of such mental health care task-shifting into HIV programs will be critical to realizing the 90–90–90 goals and ending the HIV epidemic.