Mental Health Screening and Treatment to Improve HIV Outcomes

HAI is piloting the use of the Common Elements Treatment Approach (CETA) to screen for and treat mental disorders within HIV-positive populations and improve HIV treatment outcomes.

Mental disorders and HIV are the two leading causes of all years lived with disability in Mozambique. An estimated 20-30% of people living with HIV also experience common mental disorders, such as anxiety and depression. In Mozambique, an estimated 2.2 million people are living with HIV. Unfortunately, only 7.2% of primary health facilities in the country offer mental healthcare, causing common mental illnesses to often go untreated. Research suggests that addressing these comorbidities can improve HIV treatment adherence and retention and increase the probability of viral suppression.  

HAI is addressing this challenge by piloting CETA within HIV-positive populations in Mozambique. The CETA model—designed by collaborators at the UW and Johns Hopkins University for use in low-resource settings— is a validated mental health screening tool that increases access to mental healthcare via trained lay counselors (pictured above).  CETA lay counselors screen individuals for symptoms of depression, anxiety, trauma, and substance use disorder and can provide point-of-care best-evidence psychological treatments according to each patient’s individual needs. 


In March 2019, sixteen counselors completed 2-weeks of training in CETA counseling techniques, followed by 6-weeks of applied practice. By May 2019, the newly trained counselors were screening and providing supervised care to patients in five public health facilities in Sofala Province. Over half of HIV-positive individuals screened have shown high symptoms of mental health disorder, including thoughts of suicide. After 4 sessions of CETA, patient symptoms appear to decrease by >50%.  Early indications are also suggesting that CETA can significantly increase retention in HIV treatment.

“I was a lost person. I felt lost. I was… I asked myself, am I a person at all? I said, no I do not think I’m a person. I didn’t like myself at all. I felt alone. But, when I attended this program, there were people who really helped me. They helped me the first week that I came. I was a person with a full head, but suddenly that went away.”

– Person living with HIV, screened by a CETA Lay Counselor


Want to dig a little deeper?


[2019-2020] Scale-up of a trans-diagnostic integrated mental healthcare model for HIV+ individuals with common mental disorders in Mozambique.

This project receives funding support from the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under award #U91HA06801, via a subagreement from the University of Washington.

[2018-2019] Development and implementation of a demonstration project of integrated mental healthcare for HIV+ individuals with common mental disorders.

This project received funding support from the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under award #U91HA06801, via a subagreement from the University of Washington.

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