The effectiveness of psychoeducation and problem-solving on depression and treatment adherence in adolescents living with HIV in Botswana: an exploratory clinical trial

BACKGROUND: This study aimed to explore the effectiveness of psychological interventions (PI): psychoeducation, problem-solving, and rehearsal strategies on depression and adherence in HIV-infected adolescents in Botswana. METHODS: Fifty adolescents living with HIV were randomized into control (n = 25) and intervention groups (n = 25), the latter being exposed to five weeks of PI sessions. The PHQ-9 and visual analog scale (VAS) were used to measure the outcomes: depression and adherence at pre-intervention, 5- and 24 weeks post-intervention. RESULTS: The participants’ mean age (SD) was 17.38 years (1.1), the two groups being similar in socio-demographic variables: gender (χ(2) = 2.22; p = 0.135) and age (U = 285, z = − 0.55, p = 0.579). The intervention group scored significantly lower on depressive symptoms (PHQ-9 [F (1,50) = 12.0, p = 0.001, ƞ(p)(2) = 0.20]) and higher on adherence score (VAS [F (1,50) = 13.5, p = 0.001, ƞ(p)(2) = 0.22]) than the control group after 5 weeks. The post-hoc analysis showed that the significant improvements in depressive symptoms (z = − 4.03, p < 0.01, r [effect size] = 0.88) and adherence (z = − 4.05, p < 0.01, r = 0.88) at post-test in the intervention group were maintained at 24 weeks. This project was registered with ClinicalTrials.gov (NCT05482217). CONCLUSION: The 5-week PI showed promising effectiveness in addressing depression and adherence in adolescents living with HIV in Botswana.