Developing and Testing Group Support Psychotherapy for Children and Adolescents Living with HIV in Uganda

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Abstract
After successfully developing and evaluating group support psychotherapy (GSP) as a first-line treatment for mild-to-moderate depression in adults, we aimed to adapt and assess this approach for children and adolescents (CA) (ages 10–18) living with HIV. In June 2021, 30 young people and 30 caregivers participated in separate GSP sessions. Data on psychosocial issues and GSP effectiveness were collected through focus groups and interviews. Insights were guided by the ecological validity and culturally sensitive framework. An open-label randomized controlled trial in Kitgum, with 120 participants, registered with PACTR, number 202006601935462, compared GSP plus intensive adherence counseling (IAC) to IAC alone, assessing feasibility, acceptability, depression, anxiety, and HIV treatment outcomes. We found that CA with HIV struggled with self-esteem issues, suicidal thoughts, medication adherence, and food insecurity, alongside stigma, discrimination, and limited mental health programs. The adult GSP model was adapted for CA by creating gender- and age-specific groups, simplifying language, and incorporating play and expressive art activities. Caregivers were concurrently engaged with the adult GSP model. GSP participants showed a significantly greater reduction in depression symptoms compared to IAC participants.

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