Adaptation and optimisation of the WHO Problem Management Plus (PM+) for ALHIV in adverse settings of KwaZulu-Natal, South Africa

The mental health challenges faced by adolescents living with HIV (ALHIV) impact on mortality and longterm poor health and yet remain largely unaddressed.

There is a growing number of ALHIV and the youth bulge in Africa further contributes to the increase in new HIV infections.

In South Africa, young people are simultaneously affected by HIV, poverty, inequality, violence, and the legacies of Apartheid.

This puts them at high risk of mental, cognitive, and behavioural problems contributing to worse HIV virologic responses.

Psychosocial interventions such as the ‘Friendship Bench’ and ‘WHO Problem Management Plus (PM+)’ delivered by non-mental health professionals are effective in improving mental health in resource limited settings.

However, there is growing evidence of barriers to transferability of these interventions due to various reasons including unsuitability to particular populations and contexts.

I will apply a social ecological framework to investigate ways of addressing mental health problems of ALHIV in adverse settings and elucidate mechanisms of resilience that may be associated with HIV outcomes (e.g., ART adherence, and virologic suppression). Resilience can support the adaptation process of living with HIV.

It is therefore critical to develop and implement novel multilevel resilience building interventions to improve adolescent HIV-related health outcomes.