Introduction Postpartum depression (PPD) is a prevalent and debilitating disease that may affect medication adherence and thus maternal health and vertical transmission among women with HIV. We assessed the feasibility of a trial of interpersonal psychotherapy (IPT) versus antidepressant medication (ADM) to treat PPD and/or anxiety among postpartum women with HIV in Lusaka, Zambia. Methods Between 29 October 2019 and 8 September 2020, we pre‐screened women 6–8 weeks after delivery with the Edinburgh Postnatal Depression Scale (EPDS) and diagnosed PPD or anxiety with the Mini International Neuropsychiatric Interview. Consenting participants were randomized 1:1 to up to 11 sessions of IPT or daily self‐administered sertraline and followed for 24 weeks. We assessed EPDS score, Clinical Global Impression‐Severity of Illness (CGI‐S) and medication side effects at each visit and measured maternal HIV viral load at baseline and final study visit. Retention, visit adherence, change in EPDS, CGI‐S and log viral load were compared between groups with t ‐tests and Wilcoxon signed rank tests; we report mean differences, relative risks and 95% confidence intervals. A participant satisfaction survey assessed trial acceptability. Results 78/80 (98%) participants were retained at the final study visit. In the context of the COVID‐19 pandemic, visit adherence was greater among women allocated to ADM (9.9 visits, SD 2.2) versus IPT (8.9 visits, SD 2.4; p = 0.06). EPDS scores decreased from baseline to final visit overall, though mean change was greater in the IPT group (−13.8 points, SD 4.7) compared to the ADM group (−11.4 points, SD 5.5; p = 0.04). Both groups showed similar changes in mean log viral load from baseline to final study visit (mean difference −0.43, 95% CI −0.32, 1.18; p = 0.48). In the IPT group, viral load decreased significantly from baseline (0.9 log copies/ml, SD 1.7) to final visit (0.2 log copies/ml, SD 0.9; p = 0.01). Conclusions This pilot study demonstrates that a trial of two forms of PPD treatment is feasible and acceptable among women with HIV in Zambia. IPT and ADM both improved measures of depression severity; however, a full‐scale trial is required to determine whether treatment of PPD and anxiety improves maternal–infant HIV outcomes.

Background Health protective behaviours are crucial in the prevention of the spread of COVID-19, particularly in university students who typically live and study in large groups. Depression and anxiety are common in students and can impact young people’s motivations to follow health advice. The study aims to assess the relationship between mental health and COVID-19 health-protective behaviours in Zambian university students with symptoms of low mood. Methods The study was a cross-sectional, online survey of Zambian university students. Participants were also invited to take part in a semi-structured interview to explore views about COVID-19 vaccination. Invitation emails were sent explaining the study aims and directed students who self-identified as having low mood in the past two weeks to an online survey. Measures included COVID-19 preventive behaviours, COVID-19-related self-efficacy, and Hospital and Anxiety Depression scale. Results A total of 620 students (n=308 female, n=306 male) participated in the study, with a mean participant age of 22.47±3.29 years (range 18–51). Students reported a mean protective behaviour score of 74.09/105 and 74% scored above the threshold for possible anxiety disorder. Three-way ANOVA showed lower COVID-19 protective behaviours in students with possible anxiety disorder (p=.024) and those with low self-efficacy (p<0.001). Only 168 (27%) said they would accept vaccination against COVID-19, with male students being twice as likely to be willing to accept COVID-19 vaccination (p<0.001). Of 50 students interviewed. 30 (60%) expressed fears about the vaccination and 16 (32%) were concerned about a lack of information. Only 8 (16%) participants expressed doubts about effectiveness. Conclusion Students who self-identify as having symptoms of depression have high levels of anxiety. The results suggest that interventions to reduce anxiety and promote self-efficacy might enhance students’ COVID-19 protective behaviours. Qualitative data provided insight into the high rates of vaccine hesitancy in this population.

Background: Suicidal ideation has long been associated with HIV infected populations worldwide. It has been found that HIV does not only attack the immune system of an individual but also the nervous system leading to psychological dysfunction of an individual. Objective: To establish the prevalence of suicidal ideation among people living with HIV and AIDS. Method: A cross sectional quantitative design was adopted. Systematic random sampling method was used to select the sample. The total sample comprised of 280 participants. A social demographic questionnaire and Suicidal Risk Screening Scale (SRSS) were used to collect data. Results: The study findings from the SRSS test revealed that (n=193, 69%) of the participants had lower suicide risk while (n=87, 31%) fell into the higher suicide risk category. The study therefore showed that the prevalence of suicidal ideation was 31%. Conclusion: Suicidal ideation was prevalent among people living with HIV and Aids.

Background: Hopelessness is a subjective appraisal of negative expectations about the occurrence of a highly valued outcome coupled with the sense that one lacks control over desired events in the future. Hopelessness is an early symptom of depression and is comorbid with cervical cancer. Supportive Group therapy offers an economical and time efficient solution. In Zambia and particularly at Cancer Disease Hospital such structured supportive group therapy is not being offered. This study aims to ascertain whether supportive group therapy can reduce levels of hopelessness in cervical cancer patients at Cancer disease hospital in Lusaka Zambia.Methodology: This was a Single blinded Randomized Controlled Trial conducted at Cancer Disease Hospital in Lusaka Zambia. Single blinded in the sense that participants did not know whether they would be in the control or intervention group. It was conducted between March 2019 and September 2020. Patients with histologically confirmed diagnosis of cervical cancer were recruited. Socio- demographic characteristics and clinical presentations were elicited by detailed history taking and file review. All the participants completed Pre- Hopelessness in illness (HAI) Questionnaire and their results were noted. They were then divided into a control and intervention group using computer generated numbers. The intervention group then attended one hour Supportive group therapy sessions weekly for four weeks. The control group continued to receive the usual support of their family members and Cancer disease hospital staff. Both groups were then administered the Post- Hopelessness in illness Questionnaire and their results were noted. Results: 49 patients were recruited. Patient retention was 92% (n= 45). Majority of the participants were of the age group 41-50 years i.e. control group (n =12) intervention group (n= 7). Majority were; married control (n= 11) intervention (n= 12), unemployed control (n=14) intervention (n= 18), had social support control (n=14) intervention (n= 18). Only social support correlated with lower HAI scores (p= 0.047). There was no correlation between therapy and post HAI scores as both p- values i.e. control (p= 0.683) intervention (p= 0.368) were greater than confidence interval 0.05. The intervention group had a greater reduction in HAI scores in comparison to the control group.Conclusion: There was minimal difference in treatment outcomes of cervical cancer patients receiving supportive group therapy to those not receiving supportive group therapy. However, the intervention group showed a better reduction in hopelessness (HAI scores). Social support is the only significant factor associated with lower levels of hopelessness.

Background Health protective behaviours are crucial in the prevention of the spread of COVID-19, particularly in university students who typically live and study in large groups. Depression and anxiety are common in students and can impact young people’s motivations to follow health advice. The study aims to assess the relationship between mental health and COVID-19 health-protective behaviours in Zambian university students with symptoms of low mood. Methods The study was a cross-sectional, online survey of Zambian university students. Invitation emails were sent explaining the study aims and directed students who self-identified as having low moods in the past two weeks to an online survey. Measures included COVID-19 preventive behaviours, COVID-19-related self-efficacy and Hospital and Anxiety Depression scale. Results A total of 620 students (n = 308 female, n = 306 male) participated in the study, with a mean participant age of 22.47 ± 3.29 years (range 18–51). Students reported a mean protective behaviour score of 74.09/105 and only 168 (27%) said they would accept vaccination against COVID-19, with male students being twice as likely to be willing to accept COVID-19 vaccination (p < 0.001). Over half the students (54%) scored above the threshold for depression and nearly three-quarters (74%) scored above the threshold for possible anxiety disorder. Three-way ANOVA showed lower COVID-19 protective behaviours in students scoring above the threshold for anxiety (p = .024) and those with low self-efficacy (p < 0.001). Gender was non-significant. Conclusion Students who self-identify as having symptoms of depression have high levels of anxiety. The results suggest that interventions to reduce anxiety and promote self-efficacy might enhance students’ COVID-19 protective behaviours. Further qualitative research is needed to understand the high rates of vaccine hesitancy in this population.