Other Titles
PHQ 9 and GAD 7 Screening for HIV + Women in Kenya [Title Slide]
Abstract
Background: As HIV treatment advances in sub-Saharan Africa, care for women living with HIV (WLWH) shifted from acute AIDS management to chronic disease care, with need to integrate mental health and HIV services. In low-resource settings comorbidities and antiretroviral (ARV) side effects can heighten anxiety and depression. Anemia, diabetes, hypertension, malaria, and ARV-related fatigue, pain, and neuropathy complicate diagnosis and treatment. Mental health screening in primary care improves identification and supports better outcomes. Rural and urban WLWH face different barriers and resources, emphasizing context-specific approaches. Expanding nursing education and advanced nursing roles may help reduce gaps in integrated care.
Objectives: (1) Identify prevalence and severity of anxiety (GAD-7) and depression (PHQ-9) among rural and urban Kenyan WLWH; (2) identify medical comorbidities and symptoms linked to mental health and HIV; (3) demonstrate increased screening access through expanded nursing roles.
Methods: A cross-sectional observational study used a convenience sample of WLWH enrolled in a Kenyan NGO Women’s Empowerment Program across four rural and one urban site. Participants received financial support, training, and healthcare oversight. A mobile multidisciplinary team—Kenyan and U.S. nursing faculty, nurse practitioners, a physician, and a dietician—conducted assessments including GAD-7, PHQ-9, and comorbidity screening.
Data Analysis: Among HIV+ women (N=167), 10% had moderate–severe depression and 6.5% had moderate–severe anxiety, below global estimates (32.5% in Ethiopia; 82% globally). Many women credited improved well-being to program support. Rural-urban comparisons showed limited differences as local factors influenced symptoms. Anemia screening of 237 women identified 25% who met WHO criteria for moderate–severe anemia. Likely etiologies: dietary deficiency, H. pylori, aflatoxin exposure, and esophagitis linked to groundwater fluorosis (Kenya 22.6 mg/L vs. WHO limit 1.5 mg/L). A fluorosis screening tool is under development.
Implications: Examine links between mental health scores and comorbidities in rural and urban contexts. This study highlights mental health disparities and comorbidities among Kenyan WLWH, and supports integrated care. Interprofessional teams strengthened screening and management of depression, anxiety, chronic disease, and HIV-related effects, with PHQ-9, GAD-7 use and shared training partnerships.
Notes
References:
1. Ciancio, A., Kämpfen, F., Kohler, H. P., & Kohler, I. V. (2021). Health screening for emerging non-communicable disease burdens among the global poor: Evidence from sub-Saharan Africa. Journal of Health Economics, 75, 102388. https://doi.org/10.1016/j.jhealeco.2020.102388
2. Christmals, C. D., & Armstrong, S. J. (2020). Curriculum framework for advanced practice nursing in sub- Saharan Africa: A multimethod study. BMJ Open, 10(6), e035580. https://doi.org/10.1136/bmjopen-2019- 035580
3. Eshun-Wilson, I., Siegfried, N., Akena, D. H., Stein, D. J., Obuku, E. A., & Joska, J. A. (2018). Antidepressants for depression in adults with HIV infection. The Cochrane Database of Systematic Reviews, 1(1), CD008525. https://doi.org/10.1002/14651858.CD008525.pub3
4. Gbaba, S., & Itambo, J. (2023). Advanced practice registered nurses: A solution for primary care shortages in sub-Saharan Africa. Nursing Open, 10(9), 5787–5789. https://doi.org/10.1002/nop2.1909
5. Mwangi, P., Nyongesa, M. K., Koot, H. M., Cuijpers, P., Newton, C. R. J. C., & Abubakar, A. (2020). Validation of a Swahili version of the 9-item Patient Health Questionnaire (PHQ-9) among adults living with HIV compared to a community sample from Kilifi, Kenya. Journal of Affective Disorders Reports, 1, 100013. https://doi.org/10.1016/j.jadr.2020.100013
6. Nyongesa, M. K., Mwangi, P., Koot, H. M., Cuijpers, P., Newton, C. R. J. C., & Abubakar, A. (2020). The reliability, validity and factorial structure of the Swahili version of the 7-item generalized anxiety disorder scale (GAD-7) among adults living with HIV from Kilifi, Kenya. Annals of General Psychiatry, 19, 62. https://doi.org/10.1186/s12991-020-00312-4
7.Waldron, E. M., Burnett-Zeigler, I., Wee, V., Ng, Y. W., Koenig, L. J., Pederson, A. B., Tomaszewski, E., & Miller, E. S. (2021). Mental Health in Women Living With HIV: The Unique and Unmet Needs. Journal of the International Association of Providers of AIDS Care, 20, 2325958220985665. https://doi.org/10.1177/2325958220985665
8.Yousuf, A., Mohd Arifin, S. R., Musa, R., & Md Isa, M. L. (2019). Depression and HIV Disease Progression: A Mini-Review. Clinical practice and epidemiology in mental health : CP & EMH, 15, 153–159. https://doi.org/10.2174/1745017901915010153
Sigma Membership
Zeta Eta at-Large
Type
Presentation
Format Type
Text-based Document
Study Design/Type
Cross-Sectional
Research Approach
Quantitative Research
Keywords:
Academic-Clinical Partnership, Interprofessional, Interdisciplinary, Health Equity or Social Determinants of Health, Psychology of HIV-Positive Persons, HIV-Positive Persons, Medical Screening, Kenya
Recommended Citation
Meda, Janet; Van Auker, Laura L.; Cavanagh, Stephen J.; Wagoro, Miriam Carole Atieno; and Omenda, Mariana, "USA-Kenyan Primary Care Teams Offer PHQ-9 and GAD-7 Screening for HIV+ Women in Kenya" (2026). International Nursing Research Congress (INRC). 192.
https://www.sigmarepository.org/inrc/2026/presentations_2026/192
Conference Name
37th International Nursing Research Congress
Conference Host
Sigma Theta Tau International
Conference Location
Toronto, Ontario, Canada
Conference Year
2026
Rights Holder
All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record. All permission requests should be directed accordingly and not to the Sigma Repository. All submitting authors or publishers have affirmed that when using material in their work where they do not own copyright, they have obtained permission of the copyright holder prior to submission and the rights holder has been acknowledged as necessary.
Review Type
Abstract Review Only: Reviewed by Event Host
Acquisition
Proxy-submission
Date of Issue
2026-08-23
USA-Kenyan Primary Care Teams Offer PHQ-9 and GAD-7 Screening for HIV+ Women in Kenya
Toronto, Ontario, Canada
Background: As HIV treatment advances in sub-Saharan Africa, care for women living with HIV (WLWH) shifted from acute AIDS management to chronic disease care, with need to integrate mental health and HIV services. In low-resource settings comorbidities and antiretroviral (ARV) side effects can heighten anxiety and depression. Anemia, diabetes, hypertension, malaria, and ARV-related fatigue, pain, and neuropathy complicate diagnosis and treatment. Mental health screening in primary care improves identification and supports better outcomes. Rural and urban WLWH face different barriers and resources, emphasizing context-specific approaches. Expanding nursing education and advanced nursing roles may help reduce gaps in integrated care.
Objectives: (1) Identify prevalence and severity of anxiety (GAD-7) and depression (PHQ-9) among rural and urban Kenyan WLWH; (2) identify medical comorbidities and symptoms linked to mental health and HIV; (3) demonstrate increased screening access through expanded nursing roles.
Methods: A cross-sectional observational study used a convenience sample of WLWH enrolled in a Kenyan NGO Women’s Empowerment Program across four rural and one urban site. Participants received financial support, training, and healthcare oversight. A mobile multidisciplinary team—Kenyan and U.S. nursing faculty, nurse practitioners, a physician, and a dietician—conducted assessments including GAD-7, PHQ-9, and comorbidity screening.
Data Analysis: Among HIV+ women (N=167), 10% had moderate–severe depression and 6.5% had moderate–severe anxiety, below global estimates (32.5% in Ethiopia; 82% globally). Many women credited improved well-being to program support. Rural-urban comparisons showed limited differences as local factors influenced symptoms. Anemia screening of 237 women identified 25% who met WHO criteria for moderate–severe anemia. Likely etiologies: dietary deficiency, H. pylori, aflatoxin exposure, and esophagitis linked to groundwater fluorosis (Kenya 22.6 mg/L vs. WHO limit 1.5 mg/L). A fluorosis screening tool is under development.
Implications: Examine links between mental health scores and comorbidities in rural and urban contexts. This study highlights mental health disparities and comorbidities among Kenyan WLWH, and supports integrated care. Interprofessional teams strengthened screening and management of depression, anxiety, chronic disease, and HIV-related effects, with PHQ-9, GAD-7 use and shared training partnerships.
Description
This evidence-based study highlights mental health disparities and comorbidities among Kenyan WLWH, supporting integrated care models. Interprofessional teams of Kenyan physicians, mental health nurses, and U.S. nurse practitioners strengthened screening and management of depression, anxiety, chronic disease, and HIV-related effects. The project also offered insights into PHQ-9 and GAD-7 use in this population and enhanced shared training through academic partnerships.