Suicide Assessment and Feasible Evidence-based Treatments for Youth Living With HIV in Lilongwe

University of Pennsylvania

Status: Enrolling

Conditions: HIV; Suicide

Treatments: Behavioral: Behavioral: Enhanced Friendship Bench + Safety Planning; Behavioral: Augmented usual care

Study type: Interventional

Funder types: Other; NIH

Identifiers

NCT06770101

857370

R34MH136204 (U.S. NIH Grant/Contract)

Details and patient eligibility

About

The overall aim of this study is to determine the feasibility, fidelity, acceptability, and preliminary effectiveness of the Friendship Bench +Safety Planning intervention in reducing suicidal ideation and behaviors (SIBs) and improving HIV engagement amongst adolescents living with HIV (ALWH) when compared to augmented usual care.

Full description

This project aims to evaluate the feasibility, acceptability, fidelity, and preliminary effectiveness of the enhanced Friendship Bench+Safety Planning (FB+SP) intervention model. We will enroll 60 depressed ALWH who report suicidality from four facilities in Lilongwe, Malawi, and randomize them 1:1 to the enhanced FB+SP model or augmented usual care. This pilot trial is a step toward our long-term goal of generating and implementing an evidence-based model to prevent suicide in Malawi amongst ALWH by enhancing the capacity of the health system to identify suicidality and provide evidence-based care. Information gathered in this proposal will be used to develop a subsequent randomized control trial.

Enrollment: 60 estimated patients

Sex: All

Ages: 13 to 19 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Age 13-19
• Diagnosed with HIV
• Report current or historical suicidal ideation and behaviors (SIBs) on question 9 of the Patient Health Questionnaire modified for adolescents (PHQ-9-A) and the Ask Suicide-Screening questionnaire (ASQ)
• Living in the clinic's catchment area with intention to remain for more than 1 year
• Willing to provide consent (age 18+ or 16-17 years old and married and thereby considered emancipated minors per Malawi law) or assent with parental consent (age 13-17).

Exclusion criteria

• Refuse to participate
• Refuse to be audio-taped for in-depth interviews

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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60 participants in 2 patient groups

Enhanced Friendship Bench + Safety Planning (FB+SP)

Experimental group

Description:

Friendship Bench (FB) problem-solving therapy and Safety Planning (SP)

Treatment:

Behavioral: Behavioral: Enhanced Friendship Bench + Safety Planning

Augmented Usual Care

Active Comparator group

Description:

Continue with usual outpatient care, augmented to provide mental health evaluation, brief supportive counseling, information, education and support on SIBs, and (if indicated) facilitation of referral to the clinic's psychiatric nurse or to Bwaila Hospital.

Treatment:

Behavioral: Augmented usual care