The Effect of the Shikamana Peer-and-Provider Intervention on Depressive Symptoms, Alcohol Use, and Other Drug Use Among Gay, Bisexual, and Other Men Who Have Sex with Men in Kenya

AIDS Behav. 2023 Sep;27(9):3053-3063. doi: 10.1007/s10461-023-04027-x. Epub 2023 Mar 16.

Abstract

Kenyan gay, bisexual, and other men who have sex with men (GBMSM) face stigma and discrimination, which may adversely impact mental health and limit antiretroviral therapy (ART) adherence among GBMSM living with HIV. We evaluated whether the Shikamana peer-and-provider intervention, which improved ART adherence among participants in a small randomized trial, was associated with changes in mental health or substance use. The intervention was associated with a significant decrease in PHQ-9 score between baseline and month 6 (estimated change - 2.7, 95% CI - 5.2 to - 0.2, p = 0.037) compared to standard care. In an exploratory analysis, each one-point increment in baseline HIV stigma score was associated with a - 0.7 point (95% CI - 1.3 to - 0.04, p = 0.037) greater decrease in PHQ-9 score over the study period in the intervention group. Additional research is required to understand factors that influence this intervention's effects on mental health outcomes.

Keywords: Depression; HIV; Kenya; Men who have sex with men; Mental health; Stigma.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Anti-Retroviral Agents / therapeutic use
  • Depression / drug therapy
  • Depression / epidemiology
  • Depression / psychology
  • HIV Infections* / drug therapy
  • HIV Infections* / epidemiology
  • HIV Infections* / psychology
  • Homosexuality, Male / psychology
  • Humans
  • Kenya / epidemiology
  • Male
  • Randomized Controlled Trials as Topic
  • Sexual and Gender Minorities*
  • Substance-Related Disorders* / epidemiology
  • Substance-Related Disorders* / psychology

Substances

  • Anti-Retroviral Agents