PMID- 34847908
OWN - NLM
STAT- MEDLINE
DCOM- 20211206
LR  - 20220520
IS  - 1471-2458 (Electronic)
IS  - 1471-2458 (Linking)
VI  - 21
IP  - 1
DP  - 2021 Nov 30
TI  - Mental health outcomes of a pilot 2-arm randomized controlled trial of a 
      HIV-prevention program for South African adolescent girls and young women and 
      their female caregivers.
PG  - 2189
LID - 10.1186/s12889-021-12010-1 [doi]
LID - 2189
AB  - BACKGROUND: South African adolescent girls and young women (AGYW) report 
      significant mental distress and sexual and reproductive health concerns. Mental 
      health problems and trauma symptoms are consistently associated with sexual and 
      reproductive health behavior. Despite their intersection, few interventions 
      address them simultaneously or engage female caregivers (FC) as collaborators. 
      This study presents findings from a pilot test of an empirically supported 
      culturally adapted family-based HIV-prevention program, Informed Motivated Aware 
      and Responsible Adolescents and Adults- South Africa (IMARA-SA), on AGYW anxiety, 
      depression, and trauma. METHODS: Sixty 15-19-year-old AGYW (mean 
      age = 17.1 years) and their FC from outside Cape Town were randomized to IMARA-SA 
      or a health promotion control program. AGYW reported their anxiety using the 
      GAD-7, depression using the PHQ-9, and trauma using the PC-PTSD-5 at baseline and 
      follow-up (6-10 months post). Both interventions were delivered by Xhosa-speaking 
      Black South African women in groups over 2 days for approximately 10 h. We 
      examined intervention effects using zero-inflated negative binomial regression 
      for anxiety, multinomial logistic regression for depression, and logistic 
      regression for trauma. RESULTS: At baseline, groups did not differ in demographic 
      characteristics but AGYW randomized to IMARA-SA had higher depression scores than 
      controls (p = 0.04) and a greater proportion screened positive for PTSD 
      (p = .07). Controlling for baseline mental health scores, AGYW who received 
      IMARA-SA compared to controls had significantly fewer anxiety symptoms at 
      follow-up (adjusted incidence rate ratio for count model = 0.54, 95% 
      CI = 0.29-0.99, p = 0.05), were less likely to report at least one depressive 
      symptom relative to no symptoms (relative risk ratio = 0.22, 95% CI = 0.05, 0.95, 
      p = 0.04), and were less likely to report symptoms of PTSD relative to no 
      symptoms, but this difference was not statistically significant. CONCLUSIONS: 
      Mental health is implicated in risky sexual behavior, and reducing emotional 
      distress can mitigate exposure to poor sexual and reproductive health outcomes. 
      This pilot study yielded promising findings for the mental health impact of 
      IMARA-SA, justifying replication in a larger randomized trial. TRIAL 
      REGISTRATION: ClinicalTrials.gov Number NCT04758390 , accepted 17/02/2021.
CI  - (c) 2021. The Author(s).
FAU - Donenberg, Geri
AU  - Donenberg G
AD  - Center for Dissemination and Implementation Science, Department of Medicine, 
      University of Illinois at Chicago, 818 S. Wolcott, Chicago, IL, 60612, USA. 
      gerid@uic.edu.
FAU - Merrill, Katherine G
AU  - Merrill KG
AD  - Center for Dissemination and Implementation Science, Department of Medicine, 
      University of Illinois at Chicago, 818 S. Wolcott, Chicago, IL, 60612, USA.
FAU - Atujuna, Millicent
AU  - Atujuna M
AD  - Desmond Tutu HIV Center, Cape Town, South Africa.
FAU - Emerson, Erin
AU  - Emerson E
AD  - Center for Dissemination and Implementation Science, Department of Medicine, 
      University of Illinois at Chicago, 818 S. Wolcott, Chicago, IL, 60612, USA.
FAU - Bray, Bethany
AU  - Bray B
AD  - Center for Dissemination and Implementation Science, Department of Medicine, 
      University of Illinois at Chicago, 818 S. Wolcott, Chicago, IL, 60612, USA.
FAU - Bekker, Linda Gail
AU  - Bekker LG
AD  - Desmond Tutu HIV Center, Cape Town, South Africa.
LA  - eng
SI  - ClinicalTrials.gov/NCT04758390
GR  - UH3 HD096875/HD/NICHD NIH HHS/United States
GR  - UG3 HD096875/HD/NICHD NIH HHS/United States
PT  - Journal Article
PT  - Randomized Controlled Trial
PT  - Research Support, N.I.H., Extramural
DEP - 20211130
PL  - England
TA  - BMC Public Health
JT  - BMC public health
JID - 100968562
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - *Caregivers
MH  - Female
MH  - *HIV Infections/epidemiology/prevention & control
MH  - Humans
MH  - Outcome Assessment, Health Care
MH  - Pilot Projects
MH  - Sexual Behavior
MH  - South Africa/epidemiology
PMC - PMC8630514
OTO - NOTNLM
OT  - Adolescent girls and young women
OT  - HIV prevention
OT  - Mental health
OT  - Mother-daughter intervention
OT  - South Africa
COIS- The authors declare that they have no competing interests.
EDAT- 2021/12/02 06:00
MHDA- 2021/12/15 06:00
PMCR- 2021/11/30
CRDT- 2021/12/01 05:49
PHST- 2021/07/09 00:00 [received]
PHST- 2021/10/06 00:00 [accepted]
PHST- 2021/12/01 05:49 [entrez]
PHST- 2021/12/02 06:00 [pubmed]
PHST- 2021/12/15 06:00 [medline]
PHST- 2021/11/30 00:00 [pmc-release]
AID - 10.1186/s12889-021-12010-1 [pii]
AID - 12010 [pii]
AID - 10.1186/s12889-021-12010-1 [doi]
PST - epublish
SO  - BMC Public Health. 2021 Nov 30;21(1):2189. doi: 10.1186/s12889-021-12010-1.