'I went back to being myself': acceptability of a culturally adapted task-shifted cognitive-behavioural therapy (CBT) treatment for depression (Ziphamandla) for South African HIV care settings

Everitt-Penhale, B., Kagee, A., Magidson, J. F., Joska, J., Safren, S. A., O'Cleirigh, C., Witten, J., Lee, J. S. and Andersen, L. S.

There is a need for a culturally adapted, evidence-based, psychotherapy treatment that is effective, acceptable, and feasible for integration into primary care in South Africa. This qualitative study used exit interviews to examine participants' experiences of an adapted cognitive-behavioural therapy treatment for adherence and depression, task-shifted and delivered by nurses in two peri-urban HIV clinics near Cape Town. Nine semi-structured exit interviews were conducted with isiXhosa-speaking females and analysed using thematic analysis. Overall, participants responded positively to the treatment, viewing it as acceptable and beneficial and as a catalyst to returning to normalcy. Results indicated that participants viewed the treatment as being effective in ameliorating their depressive symptoms and improving their adherence to ART . Additional benefits described included improvements in subjective wellbeing and social and occupational functioning. Several began or resumed employment, an important behavioural indicator of the treatment's capacity to facilitate positive change and cost saving. Recommendations to improve the treatment included using video material and educating others about depression. These findings have positive implications regarding the acceptability and cultural applicability of the treatment for use in South Africa.

April 12, 2019
Year of publication
Resource types
Journal and research articles
depression, HIV care, cognitive behavioural therapy (CBT), South Africa, antiretroviral therapy (ART)

Similar Resources

The lesbian, gay, bisexual, transgender and intersex (LGBTI) case study was undertaken by the National Population Unit (NPU) to assess the activities that are run by the organisation OUT. This study forms part of 10 such studies with regard to youth which was undertaken by the NPU.

BACKGROUND: Little is known about contextual factors that predict long-term mortality following HIV testing in resource-limited settings.

Many of the risk factors for violence against children are particularly prevalent in families and communities affected by HIV/AIDS.

Community-based responses have a lengthy history. The ravages of HIV on family functioning has included a widespread community response. Although much funding has been invested in front line community-based organisations (CBO), there was no equal investment in evaluations.

The World Health Organization recommends early initiation of HIV antiretroviral therapy (ART) for all those infected with the virus at any CD4 count.

This article is featured in the SHARE Research Digest. Click here to learn more.

Depression is a leading cause of disability and may be associated with decreased adherence to ART. We sought to describe the prevalence of depressive symptoms and outcomes one year after screening among patients receiving ART at a large HIV Clinic in Johannesburg, South Africa.
Antiretroviral adherence is vital to the successful long-term rollout of the antiretroviral therapy program in South Africa. At present, there are no studies that look at the effects of disability on antiretroviral adherence.
This study investigated perinatal depressive symptoms among HIV-infected women enrolled in a cluster-randomized, controlled trial in South Africa.