Mental disorders often co-occur with HIV/AIDS, yet continue to be left undiagnosed and untreated in Kenya. These disorders are associated with poor medication adherence, risky sexual behavior, and ultimately the continued spread of HIV/AIDS. Therefore, there is a critical need for effective assessment and treatment of mental disorders such as major depression and alcohol use disorders particularly among people living with or at risk for HIV/AIDS. Although major advances in the effective assessment and treatment of psychiatric and alcohol use disorders have been made, these evidence-based methods are often not adapted and tested in developing countries such as Kenya. The broad objective of this International Research Scientist Development Award (IRSDA) is to promote evidence-based assessment and treatment of psychiatric and alcohol use disorders through a translational approach that is both culturally appropriate and sustainable.
The specific aims of the research plan are to 1) Assess the prevalence of psychiatric and alcohol use disorders among adults living with HIV/AIDS and adults being tested for HIV at a health clinic located in a slum community of Nairobi, Kenya, and 2) Implement and evaluate the feasibility and acceptability of a culturally relevant, sustainable, mental health referral and alcohol use disorder intervention program for these adults. The candidate will conduct both qualitative and quantitative tests of the psychometric properties of all assessment tools and intervention programs to be implemented. Supervised clinical psychology Masters students will be used for this sustainable treatment model. The long-term objectives of this research are to help build the capacity of primary care health clinics in underprivileged areas of Kenya such that they are able to promote mental health care for all their patients and particularly the growing number with alcohol use disorders. The candidate proposes to implement this research plan during a period of close mentored training with experts in mental health assessment and treatment in both the United States and Kenya. The proposed mentored training for the candidate will enable her transition towards independence as an international mental health epidemiologist.
The proposed mental health research among people living with or at risk for HIV/AIDS in Kenya will directly benefit the health of the adults in the study as well as help train Kenyan mental health clinicians in evidence- based assessment and treatment of psychiatric and alcohol use disorders. The public health significance of this research is centered upon building capacity to treat mental disorders in Kenya effectively as well as aid in prevention efforts to decrease the spread of HIV/AIDS.
|Vurbic, Drina; Harder, Valerie S; Redner, Ryan R et al. (2015) Co-occurring obesity and smoking among U.S. women of reproductive age: Associations with educational attainment and health biomarkers and outcomes. Prev Med 80:60-6|
|Harder, Valerie S; Ayer, Lynsay A; Rose, Gail L et al. (2014) Alcohol, moods and male-female differences: daily interactive voice response over 6 months. Alcohol Alcohol 49:60-5|
|Fondacaro, Karen M; Harder, Valerie S (2014) Connecting Cultures: A training model promoting evidence-based psychological services for refugees. Train Educ Prof Psychol 8:320-327|
|Redner, Ryan; White, Thomas J; Harder, Valerie S et al. (2014) Vulnerability to smokeless tobacco use among those dependent on alcohol or illicit drugs. Nicotine Tob Res 16:216-23|
|Harder, Valerie S; Mutiso, Victoria N; Khasakhala, Lincoln I et al. (2014) Emotional and Behavioral Problems among Impoverished Kenyan Youth: Factor Structure and Sex-Differences. J Psychopathol Behav Assess 36:580-590|
|Redner, Ryan; White, Thomas J; Harder, Valerie S et al. (2014) Examining vulnerability to smokeless tobacco use among adolescents and adults meeting diagnostic criteria for major depressive disorder. Exp Clin Psychopharmacol 22:316-22|
|Makayoto, Lyndah A; Omolo, Jared; Kamweya, Abel M et al. (2013) Prevalence and associated factors of intimate partner violence among pregnant women attending Kisumu District Hospital, Kenya. Matern Child Health J 17:441-7|
|Harder, Valerie S; Mutiso, Victoria N; Khasakhala, Lincoln I et al. (2012) Multiple traumas, postelection violence, and posttraumatic stress among impoverished Kenyan youth. J Trauma Stress 25:64-70|
|Ayer, Lynsay A; Harder, Valerie S; Rose, Gail L et al. (2011) Drinking and stress: an examination of sex and stressor differences using IVR-based daily data. Drug Alcohol Depend 115:205-12|
|Khasakhala, L; Sorsdahl, K R; Harder, V S et al. (2011) Lifetime mental disorders and suicidal behaviour in South Africa. Afr J Psychiatry (Johannesbg) 14:134-9|