{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T19:35:59Z","timestamp":1790710559613,"version":"4.1.0"},"reference-count":73,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2015,3,23]],"date-time":"2015-03-23T00:00:00Z","timestamp":1427068800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000025","name":"National Institute of Mental Health","doi-asserted-by":"crossref","award":["1R21MH094156-01"],"award-info":[{"award-number":["1R21MH094156-01"]}],"id":[{"id":"10.13039\/100000025","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Tropical Med Int Health"],"published-print":{"date-parts":[[2015,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To document the lived experiences of people with both poor mental health and suboptimal adherence to antiretroviral therapy in high<jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content>prevalence settings.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In\u2010depth qualitative interviews were conducted with 47 (female\u00a0=\u00a031)<jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content>\u2010positive adults who scored above the cut\u2010point on a locally validated scale for common mental disorders (CMDs). Purposive sampling was used to recruit participants with evidence of poor adherence. Six additional key informant interviews (female\u00a0=\u00a06) were conducted with healthcare workers. Data were collected and analysed inductively by an interdisciplinary coding team.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The major challenges faced by participants were stressors (poverty, stigma, marital problems) and symptoms of CMDs (\u2018thinking too much\u2019, changes to appetite and sleep, \u2018burdened heart\u2019 and low energy levels). Thinking too much, which appears closely related to rumination, was the symptom with the greatest negative impact on adherence to antiretroviral therapy among<jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content>\u2010positive adults with CMDs. In turn, thinking too much was commonly triggered by the stressors faced by people living with<jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content>\/<jats:styled-content style=\"fixed-case\">AIDS<\/jats:styled-content>, especially poverty. Finally, participants desired private counselling, access to income\u2010generating activities and family engagement in mental health care.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Better understanding of the local expression of mental disorders and of underlying stressors can inform the development of culturally sensitive interventions to reduce CMDs and poor adherence to antiretroviral therapy.<\/jats:p><\/jats:sec>","DOI":"10.1111\/tmi.12502","type":"journal-article","created":{"date-parts":[[2015,3,7]],"date-time":"2015-03-07T08:12:53Z","timestamp":1425715973000},"page":"903-913","source":"Crossref","is-referenced-by-count":67,"title":["\u2018I was thinking too much\u2019: experiences of<scp>HIV<\/scp>\u2010positive adults with common mental disorders and poor adherence to antiretroviral therapy in Zimbabwe"],"prefix":"10.1111","volume":"20","author":[{"given":"Khameer","family":"Kidia","sequence":"first","affiliation":[{"name":"Arnhold Global Health Institute Icahn School of Medicine at Mount Sinai New York NY USA"},{"name":"University of Zimbabwe College of Health Sciences Harare Zimbabwe"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Debra","family":"Machando","sequence":"additional","affiliation":[{"name":"University of Zimbabwe College of Health Sciences Harare Zimbabwe"},{"name":"Women's University in Africa Harare Zimbabwe"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tarisai","family":"Bere","sequence":"additional","affiliation":[{"name":"University of Zimbabwe College of Health Sciences Harare Zimbabwe"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kirsty","family":"Macpherson","sequence":"additional","affiliation":[{"name":"Institute of Psychiatry King's College London London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Primrose","family":"Nyamayaro","sequence":"additional","affiliation":[{"name":"University of Zimbabwe College of Health Sciences Harare Zimbabwe"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucy","family":"Potter","sequence":"additional","affiliation":[{"name":"Institute of Psychiatry King's College London London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tariro","family":"Makadzange","sequence":"additional","affiliation":[{"name":"University of Zimbabwe College of Health Sciences Harare Zimbabwe"},{"name":"Ragon Institute of MGH MIT and Harvard Cambridge MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ronald","family":"Munjoma","sequence":"additional","affiliation":[{"name":"University of Zimbabwe College of Health Sciences Harare Zimbabwe"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marshall","family":"Marufu","sequence":"additional","affiliation":[{"name":"University of Zimbabwe College of Health Sciences Harare Zimbabwe"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ricardo","family":"Araya","sequence":"additional","affiliation":[{"name":"Department of Population Health London School of Hygiene and Tropical Medicine London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven","family":"Safren","sequence":"additional","affiliation":[{"name":"Department of Psychiatry Massachusetts General Hospital Harvard Medical School Boston MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Conall","family":"O'Cleirigh","sequence":"additional","affiliation":[{"name":"Department of Psychiatry Massachusetts General Hospital Harvard Medical School Boston MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dixon","family":"Chibanda","sequence":"additional","affiliation":[{"name":"University of Zimbabwe College of Health Sciences Harare Zimbabwe"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melanie","family":"Abas","sequence":"additional","affiliation":[{"name":"University of Zimbabwe College of Health Sciences Harare Zimbabwe"},{"name":"Institute of Psychiatry King's College London London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2015,3,23]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/dyu038"},{"key":"e_1_2_7_3_1","first-page":"858","article-title":"The treatment gap in mental health care","volume":"82","author":"Kohn R","year":"2004","journal-title":"Bull World Health Org"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc08-1341"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.yebeh.2013.03.029"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(07)61238-0"},{"key":"e_1_2_7_7_1","first-page":"112","article-title":"A review of treatment studies of depression in HIV","volume":"14","author":"Olatunji BO","year":"2006","journal-title":"Topics HIV Med"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.2989\/AJAR.2009.8.2.1.853"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/QAI.0000000000000258"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2458-8-265"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10461-008-9435-8"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1177\/1545109710361383"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10461-011-0087-8"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1097\/QAD.0b013e32835bde0f"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0014252"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.0030438"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1097\/COH.0b013e328333ad61"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1097\/QAI.0B013E31822D490A"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11904-014-0220-1"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0005-7967(00)00091-7"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.4088\/JCP.13r08710"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.72.3.400"},{"key":"e_1_2_7_23_1","doi-asserted-by":"publisher","DOI":"10.1037\/a0017206"},{"key":"e_1_2_7_24_1","doi-asserted-by":"publisher","DOI":"10.1097\/PSY.0b013e3181777a5f"},{"key":"e_1_2_7_25_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.285.11.1466"},{"key":"e_1_2_7_26_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.psy.0000188569.58998.c8"},{"key":"e_1_2_7_27_1","unstructured":"TsaiA ChanB BoumY HabererJ KembabaziAet\u00a0al.Mental Health and Mortality in an HIV Treatment Cohort in Rural Uganda; 2014 March 3\u20136 2014;Boston MA IAS\u2010USA."},{"key":"e_1_2_7_28_1","doi-asserted-by":"publisher","DOI":"10.1080\/13548506.2011.579990"},{"key":"e_1_2_7_29_1","doi-asserted-by":"publisher","DOI":"10.1111\/tmi.12382"},{"key":"e_1_2_7_30_1","doi-asserted-by":"publisher","DOI":"10.1186\/1756-0500-5-499"},{"key":"e_1_2_7_31_1","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/dyi072"},{"key":"e_1_2_7_32_1","volume-title":"Malignant Sadness: the Anatomy of Depression","author":"Wolpert L","year":"2001"},{"issue":"1","key":"e_1_2_7_33_1","first-page":"1","article-title":"The factor structure and presentation of depression among HIV\u2010positive adults in Uganda","volume":"19","author":"Psaros C","year":"2014","journal-title":"AIDS Behav"},{"key":"e_1_2_7_34_1","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.164.3.293"},{"key":"e_1_2_7_35_1","doi-asserted-by":"publisher","DOI":"10.1017\/S003329170003316X"},{"key":"e_1_2_7_36_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0033291796004163"},{"key":"e_1_2_7_37_1","doi-asserted-by":"publisher","DOI":"10.1017\/S003329170003316X"},{"key":"e_1_2_7_38_1","doi-asserted-by":"publisher","DOI":"10.1177\/1363461506064871"},{"key":"e_1_2_7_39_1","doi-asserted-by":"crossref","first-page":"36","DOI":"10.4314\/thrb.v12i1.56277","article-title":"Understanding women's experiences of distress during pregnancy in Dar es Salaam, Tanzania","volume":"12","author":"Kaaya SF","year":"2010","journal-title":"Tanzan J Health Res"},{"key":"e_1_2_7_40_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11013-010-9170-2"},{"key":"e_1_2_7_41_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11013-014-9381-z"},{"key":"e_1_2_7_42_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1548-1387.2012.01224.x"},{"key":"e_1_2_7_43_1","doi-asserted-by":"publisher","DOI":"10.1177\/1363461513502697"},{"key":"e_1_2_7_44_1","doi-asserted-by":"publisher","DOI":"10.1176\/appi.books.9780890425596"},{"key":"e_1_2_7_45_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cpr.2008.10.003"},{"key":"e_1_2_7_46_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2458-11-828"},{"key":"e_1_2_7_47_1","doi-asserted-by":"publisher","DOI":"10.1097\/00002030-200007070-00019"},{"key":"e_1_2_7_48_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2458-14-343"},{"key":"e_1_2_7_49_1","doi-asserted-by":"publisher","DOI":"10.1080\/09540120701203915"},{"key":"e_1_2_7_50_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10461-013-0538-5"},{"key":"e_1_2_7_51_1","doi-asserted-by":"publisher","DOI":"10.1037\/a0028208"},{"key":"e_1_2_7_52_1","doi-asserted-by":"publisher","DOI":"10.1037\/a0012715"},{"key":"e_1_2_7_53_1","first-page":"1101","article-title":"Qualitative methods: what are they and why use them?","volume":"34","author":"Sofaer S","year":"1999","journal-title":"Health Serv Res"},{"key":"e_1_2_7_54_1","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1234-988X(199610)6:3<153::AID-MPR157>3.3.CO;2-H"},{"key":"e_1_2_7_55_1","unstructured":"StraussA&CorbinJ.Basics of Qualitative Research: Grounded theory procedures and techniques.1990."},{"key":"e_1_2_7_56_1","unstructured":"GlaserBG&StraussAL.The Discovery of Grounded Theory: Strategies for qualitative research.1967."},{"key":"e_1_2_7_57_1","doi-asserted-by":"publisher","DOI":"10.1080\/09540120701244943"},{"key":"e_1_2_7_58_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0097353"},{"key":"e_1_2_7_59_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10461-009-9533-2"},{"key":"e_1_2_7_60_1","doi-asserted-by":"publisher","DOI":"10.1080\/09540120802032643"},{"key":"e_1_2_7_61_1","doi-asserted-by":"publisher","DOI":"10.1002\/hpm.1082"},{"key":"e_1_2_7_62_1","doi-asserted-by":"publisher","DOI":"10.1086\/313849"},{"key":"e_1_2_7_63_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1745-6924.2008.00088.x"},{"key":"e_1_2_7_64_1","doi-asserted-by":"publisher","DOI":"10.4236\/health.2013.53A074"},{"key":"e_1_2_7_65_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.healthplace.2011.07.008"},{"key":"e_1_2_7_66_1","first-page":"609","article-title":"Poverty and common mental disorders in developing countries","volume":"81","author":"Patel V","year":"2003","journal-title":"Bull World Health Organ"},{"key":"e_1_2_7_67_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(11)60754-X"},{"key":"e_1_2_7_68_1","volume-title":"Zimbabwe National Mental Health Policy","author":"Ministry of Health and Child Care","year":"2005"},{"key":"e_1_2_7_69_1","unstructured":"H Pitorak M Duffy M Sharer 2012 USAID's AIDS Support and Technical Assistance Resources AIDSTAR\u2010One Task Order 1 Arlington VA"},{"key":"e_1_2_7_70_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10823-012-9178-x"},{"key":"e_1_2_7_71_1","doi-asserted-by":"publisher","DOI":"10.1080\/09540120412331305179"},{"key":"e_1_2_7_72_1","doi-asserted-by":"publisher","DOI":"10.1089\/108729102760330272"},{"key":"e_1_2_7_73_1","doi-asserted-by":"publisher","DOI":"10.1089\/apc.2008.0201"},{"key":"e_1_2_7_74_1","doi-asserted-by":"publisher","DOI":"10.1089\/108729103321655890"}],"container-title":["Tropical Medicine &amp; International Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Ftmi.12502","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/tmi.12502","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,6,7]],"date-time":"2024-06-07T17:45:40Z","timestamp":1717782340000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/tmi.12502"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015,3,23]]},"references-count":73,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2015,7]]}},"alternative-id":["10.1111\/tmi.12502"],"URL":"https:\/\/doi.org\/10.1111\/tmi.12502","archive":["Portico"],"relation":{},"ISSN":["1360-2276","1365-3156"],"issn-type":[{"value":"1360-2276","type":"print"},{"value":"1365-3156","type":"electronic"}],"subject":[],"published":{"date-parts":[[2015,3,23]]}}}