Collaborative Care Model to Support Mental Health and HIV Care for Pregnant Women with HIV in Kenya

What this Trial Is About

Researchers are evaluating a collaborative care model to improve mental health, pregnancy, and HIV outcomes among pregnant and postpartum women living with HIV who have common mental health disorders in Kenya. This study aims to tailor and integrate mental health services within routine antenatal and HIV care to address depression, anxiety, stigma, and intimate partner violence, ultimately supporting better health for women and their families in sub-Saharan Africa. The study will introduce the Tunawiri Collaborative Care Model CCM, which includes clinic sensitization, screening for mental health symptoms, problem-solving therapy delivered by lay health workers, electronic health monitoring, and psychiatrist case review with nurse-managed medication. This model will be integrated into existing antenatal care clinics with multidisciplinary teams, including peer mentor mothers and psychiatric nurses. The intervention will be tested through a stepped wedge trial across 15 primary health care facilities. Participants will be assessed at baseline, 6 months postpartum, and 12 months postpartum for recovery from depression and anxiety, retention in HIV care, and viral suppression. Infant outcomes such as birth weight, HIV test results, and retention in care will also be monitored. Data collection includes interviews, focus groups, and clinic checklists to evaluate feasibility, acceptability, cost-effectiveness, and potential for scale-up. The total study duration extends through 12 months postpartum with ongoing stakeholder engagement and dissemination efforts.

Integrated Mental Health Care for Pregnant Women With HIV in Kenya: The Tunawiri Study