Tanzania AIDS Malignancies Training and Research Program (TAMTRP)

Despite the progress in the fight against HIV/AIDS, women around the world remain disproportionately affected by HIV. More than half of the HIV cases globally are women, and young women are as twice as likely as young men to acquire HIV. Biological factors have all been suggested to increase women’s risk to

HIV, and are compounded by social factors such as stigma, social norms, and barriers to accessing sexual and reproductive health services. Consequently, women living with HIV (WLWH) experience mental health illnesses like stress, depression, anxiety, and posttraumatic stress symptoms at higher rates than their male

counterparts and more often than HIV-unaffected women. These mental health issues affect not only the well-being and quality of life of WLWH but have implications for HIV management and transmission prevention. While mental illnesses have significant impact on management of HIV disease, data on the burden of mental illnesses and their impact in SSA where most of the PLHIV are residing is lacking. The lack

of well-trained HIV researchers in mental health and women’s health has also contributed to the low understanding of comorbidities affecting WLWH in SSA. Therefore, there is a need to build research capacity in HIV and mental health particularly among WLWH by investigating the impact of depression on health of

WLWH in SSA countries like Tanzania, where HIV prevalence is still high at 4.4% in the general population but higher in women at 5.6%. The ongoing Tanzania AIDS Malignancies Research and Training Program D43 (TW012277) provides a unique opportunity to train young investigators in the field of HIV-associated

malignancy research to address some of the challenges highlighted. We are proposing to mentor a junior female faculty oncologist who can lead a study in establishing the burden and impact of depression on health of WLWH in the country. We hypothesize that WLWH, especially those diagnosed with cancers, will have

high rates of depression, and this condition will negatively influence their ability to control HIV disease. To test this hypothesis, the team will: a) enroll women (HIV+/HIV-, and cancer+/cancer-) at Ocean Road Cancer Institute in Tanzania and establish the burden of depression among WLWH by using a validated depression

assessment tool, PHQ-9. Information on ART use and its adherence, CD4 counts, HIV viral load, and HIV disease stage will also be systematically documented; b) assess the impact of depression on health of WLWH by analyzing severity of depression and how it affects outcomes of WLWH in terms of ART adherence, HIV

plasma viral load suppression, and HIV disease stage. The proposed study will provide a unique opportunity for a new investigator (Dr. Queen) to acquire new skills in HIV, mental health, and women’s health research as a stepping-stone to embark on HIV/AIDS research career and improve research capacity in Tanzania.

The generated mental health and outcomes data will be important preliminary data for future research and crucial in designing future strategies to improve health outcomes for WLWH in SSA and beyond.