{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T09:10:57Z","timestamp":1790327457188,"version":"4.1.0"},"reference-count":45,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100000025","name":"National Institute of Mental Health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000025","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Int AIDS Soc."],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>In eastern, central and southern Africa, HIV is a leading cause of mortality, and both HIV and depression contribute substantially to morbidity. Depression can impede effective HIV treatment and prevention, yet access to depression treatment remains limited. We estimated the impact and cost\u2010effectiveness of scaling up depression screening and treatment to different population segments in western Kenya\n.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We adapted a previously validated HIV transmission model for western Kenya (EMOD\u2010HIV) to include age\u2010 and sex\u2010specific depression incidence, remission and recurrence. The model incorporated depression's effects on HIV risk; HIV testing and linkage to care; antiretroviral therapy (ART) adherence; and ART retention. We evaluated four depression screening and treatment scale\u2010up strategies for adults aged 15+ years: (1) universal screening\/treatment for all adults; (2) co\u2010administering depression and HIV screening; (3) screening ART recipients; and (4) screening ART recipients with unsuppressed viral load. We assumed 62% depression treatment efficacy and calculated costs from the provider perspective, including US$3.35 for depression screening and US$20.32 per person for psychotherapy; future costs were discounted at 3%, and costs were varied in sensitivity analyses. We calculated incremental cost\u2010effectiveness ratios as the cost (2024 USD) of depression screening and treatment per overall and HIV\u2010related disability\u2010adjusted life\u2010year (DALY) averted.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Without depression treatment, we projected 129,000 new HIV infections, 95,900 HIV\u2010related deaths and 1.83\u00a0M depression episodes between 2025 and 2035. Universal screening had the highest impact, averting 29.3% (95% CI 29.2%\u201329.3%) of person\u2010years lived with depression, 2.8% (95% CI 2.6%\u20133.1%) of HIV acquisitions and 1.4% (95% CI 1.3%\u20131.6%) of HIV deaths. The cost\u2010effectiveness of universal screening and treatment was US$1291 per DALY averted (95% CI: $1288\u20131296). Screening ART clients was most cost\u2010effective at $744 per DALY averted (95% CI: $730\u2013760), followed by screening ART clients with unsuppressed viral load at $752 per DALY averted (95% CI: $710\u2013799). Co\u2010administering HIV and depression was dominated by other strategies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Integrating depression interventions into HIV care could substantially reduce both depression and HIV burden. Cost\u2010effective scale\u2010up could initially focus on individuals with unsuppressed viral load, then to all ART recipients, and finally expand to communities.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jia2.70186","type":"journal-article","created":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T06:03:46Z","timestamp":1788329026000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Cost\u2010Effectiveness and Impact of Depression Treatment Implementation on HIV Outcomes in Western Kenya: A Mathematical Modelling Study"],"prefix":"10.1002","volume":"29","author":[{"given":"Daniel T.","family":"Citron","sequence":"first","affiliation":[{"name":"Department of Population Health NYU Grossman School of Medicine  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hae\u2010Young","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Population Health NYU Grossman School of Medicine  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roscoe","family":"Kasujja","sequence":"additional","affiliation":[{"name":"School of Psychology Makerere University  Kampala Uganda"},{"name":"StrongMinds Uganda  Kampala Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Khamisi","family":"Musanje","sequence":"additional","affiliation":[{"name":"School of Psychology Makerere University  Kampala Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samuel M.","family":"Mwalili","sequence":"additional","affiliation":[{"name":"Department of Statistics &amp; Actuarial Science Jomo Kenyatta University of Agriculture and Technology (JKUAT) Nairobi Kenya"},{"name":"Center for Health Analysis and Modeling Strathmore University  Nairobi Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4447-2734","authenticated-orcid":false,"given":"Duncan Kioi","family":"Gathungu","sequence":"additional","affiliation":[{"name":"Center for Health Analysis and Modeling Strathmore University  Nairobi Kenya"},{"name":"Department of\u00a0Pure and Applied Mathematics Jomo Kenyatta University of Agriculture and Technology (JKUAT)  Nairobi Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peris","family":"Wambui","sequence":"additional","affiliation":[{"name":"Division of Mental Health Ministry of Health  Nairobi Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chikumbi","family":"Chambwe","sequence":"additional","affiliation":[{"name":"Centre for Infectious Disease Research in Zambia  Lusaka Zambia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ingrida","family":"Platais","sequence":"additional","affiliation":[{"name":"Department of Population Health NYU Grossman School of Medicine  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frey B.","family":"Assefa","sequence":"additional","affiliation":[{"name":"Department of Population Health NYU Grossman School of Medicine  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mellesia","family":"Jeetoo","sequence":"additional","affiliation":[{"name":"Department of Population Health NYU Grossman School of Medicine  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R. 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