{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,17]],"date-time":"2025-11-17T20:47:40Z","timestamp":1763412460916,"version":"3.45.0"},"reference-count":89,"publisher":"Public Library of Science (PLoS)","issue":"11","license":[{"start":{"date-parts":[[2025,11,17]],"date-time":"2025-11-17T00:00:00Z","timestamp":1763337600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/publicdomain\/zero\/1.0\/"}],"funder":[{"DOI":"10.13039\/100000061","name":"Fogarty International Center","doi-asserted-by":"publisher","award":["NIH\/FIC grant #D43 TW009340"],"award-info":[{"award-number":["NIH\/FIC grant #D43 TW009340"]}],"id":[{"id":"10.13039\/100000061","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Adolescents living with HIV (ALHIV) face a higher risk of mental health problems than adolescents without HIV yet culturally appropriate mental health screening tools are lacking in settings like Malawi. This study aimed to culturally adapt the HEADSS (Home, Education, Activities, Drugs, Sexuality, Suicide\/Depression) psychosocial screening tool for the Malawian context, as the original was previously found to be inappropriate.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The study was conducted between December 2021 and May 2022. We employed an adapted Heuristic Framework for cultural adaptation translations. Data was collected with Mental Health experts (n\u2009=\u20094), focus group discussions with ALHIV (n\u2009=\u200920), in-depth interviews with health care providers (HCPs) (n\u2009=\u20096) and key informants (n\u2009=\u20094). An iterative process of piloting and feedback guided the adaptation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The adaptation addressed conceptually difficult, unacceptable, or stigmatizing items. HCPs reported that the adapted HEADSS tool may effectively guide the examination of ALHIV challenges and simplify the identification of high-risk behaviors (e.g., early sexual debut, self-harm and substance abuse). The tool\u2019s language was culturally accepted by ALHIV, as the screening questions were available in both the local language and English, and accurately reflected their daily challenges.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Developing easy-to-use, comprehensible, and locally appropriate mental health screening tools is crucial for detecting high-risk behaviors and psychosocial issues among ALHIV. To effectively meet ALHIVs\u2019 needs within HIV services, mental health interventions are essential for improving adherence to antiretroviral therapy (ART). Therefore, training HCPs to address sensitive risk issues during routine care is highly recommended.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pone.0318738","type":"journal-article","created":{"date-parts":[[2025,11,17]],"date-time":"2025-11-17T18:34:38Z","timestamp":1763404478000},"page":"e0318738","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Cultural adaptation of a psychosocial screening tool for adolescents living with HIV\/AIDS attending antiretroviral therapy program in Malawi"],"prefix":"10.1371","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0450-0603","authenticated-orcid":true,"given":"Esther C.","family":"Kip","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mina C.","family":"Hosseinipour","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kazione","family":"Kulisewa","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brian W.","family":"Pence","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8769-4313","authenticated-orcid":true,"given":"Michael","family":"Udedi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bradley N.","family":"Gaynes","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vivian F.","family":"Go","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2025,11,17]]},"reference":[{"key":"pone.0318738.ref001","doi-asserted-by":"crossref","first-page":"100332","DOI":"10.1016\/j.ssmph.2018.100332","article-title":"Development and validation of a 20-item screening scale to detect major depressive disorder among adolescents with HIV in rural Uganda: A mixed-methods study","volume":"7","author":"S Ashaba","year":"2018","journal-title":"SSM Popul Health"},{"key":"pone.0318738.ref002","doi-asserted-by":"crossref","first-page":"21497","DOI":"10.7448\/IAS.20.4.21497","article-title":"Mental health challenges among adolescents living with HIV","volume":"20","author":"RC Vreeman","year":"2017","journal-title":"J Int AIDS Soc"},{"key":"pone.0318738.ref003","article-title":"Adapting culturally appropriate mental health screening tools for use among conflict-affected and other vulnerable adolescents in Nigeria","volume":"6","author":"BN Kaiser","year":"2019","journal-title":"Glob Ment Health (Camb)"},{"key":"pone.0318738.ref004","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1521\/aeap.2006.18.supp.59","article-title":"Adapting evidence-based behavioral interventions for new settings and target populations","volume":"18","author":"VS McKleroy","year":"2006","journal-title":"AIDS Educ Prev"},{"issue":"2","key":"pone.0318738.ref005","doi-asserted-by":"crossref","first-page":"334","DOI":"10.1111\/famp.12381","article-title":"A Culturally Adapted Intervention for Mexican-Origin Parents of Adolescents: The Need to Overtly Address Culture and Discrimination in Evidence-Based Practice","volume":"58","author":"R Parra-Cardona","year":"2019","journal-title":"Fam Process"},{"issue":"4","key":"pone.0318738.ref006","doi-asserted-by":"crossref","first-page":"566","DOI":"10.1177\/1363461508100783","article-title":"Adapting the SRQ for Ethiopian populations: a culturally-sensitive psychiatric screening instrument","volume":"45","author":"R Youngmann","year":"2008","journal-title":"Transcult Psychiatry"},{"issue":"1","key":"pone.0318738.ref007","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1186\/s40359-014-0031-6","article-title":"Adaptation and testing of psychosocial assessment instruments for cross-cultural use: an example from the Thailand Burma border","volume":"2","author":"EE Haroz","year":"2014","journal-title":"BMC Psychol"},{"issue":"1","key":"pone.0318738.ref008","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1007\/s10560-020-00664-6","article-title":"Adaptation of a Mental Health Treatment Engagement Intervention for Older Foster Youth","volume":"38","author":"SC Narendorf","year":"2020","journal-title":"Child Adolesc Soc Work J"},{"issue":"4","key":"pone.0318738.ref009","doi-asserted-by":"crossref","first-page":"269","DOI":"10.1521\/aeap.2013.25.4.269","article-title":"Cross-cultural adaptation of an adolescent HIV prevention program: social validation of social contexts and behavior among Botswana adolescents","volume":"25","author":"JS St Lawrence","year":"2013","journal-title":"AIDS Educ Prev"},{"issue":"10","key":"pone.0318738.ref010","doi-asserted-by":"crossref","first-page":"1265","DOI":"10.1177\/1359105315626783","article-title":"Cultural adaptation of a cognitive-behavioural intervention to improve adherence to antiretroviral therapy among people living with HIV\/AIDS in Zimbabwe: Nzira Itsva","volume":"22","author":"T Bere","year":"2017","journal-title":"J Health Psychol"},{"issue":"4","key":"pone.0318738.ref011","doi-asserted-by":"crossref","first-page":"361","DOI":"10.1037\/a0016401","article-title":"Cultural adaptation of treatments: A resource for considering culture in evidence-based practice.","volume":"40","author":"G Bernal","year":"2009","journal-title":"Professional Psychology: Research and Practice"},{"issue":"2","key":"pone.0318738.ref012","doi-asserted-by":"crossref","first-page":"196","DOI":"10.1037\/a0027085","article-title":"Cultural adaptations of behavioral health interventions: a progress report","volume":"81","author":"Jr Barrera M","year":"2013","journal-title":"J Consult Clin Psychol"},{"issue":"3","key":"pone.0318738.ref013","doi-asserted-by":"crossref","first-page":"285","DOI":"10.1177\/136346159903600304","article-title":"Preparing Instruments for Transcultural Research: Use of the Translation Monitoring Form with Nepali-Speaking Bhutanese Refugees","volume":"36","author":"M van Ommeren","year":"1999","journal-title":"Transcult Psychiatry"},{"key":"pone.0318738.ref014","first-page":"650","article-title":"The Cultural Adaptation of Step-by-Step: An Intervention to Address Depression Among Chinese Young Adults. Front Psychiatry [Internet","volume":"11","author":"HF Sit","year":"2020"},{"issue":"1","key":"pone.0318738.ref015","doi-asserted-by":"crossref","DOI":"10.2196\/11600","article-title":"Cultural Adaptation of a Scalable World Health Organization E-Mental Health Program for Overseas Filipino Workers","volume":"3","author":"MR Garabiles","year":"2019","journal-title":"JMIR Form Res"},{"issue":"1","key":"pone.0318738.ref016","doi-asserted-by":"crossref","first-page":"56","DOI":"10.1111\/j.1545-5300.2012.01386.x","article-title":"Culturally adapting an evidence-based parenting intervention for Latino immigrants: the need to integrate fidelity and cultural relevance","volume":"51","author":"JR Parra Cardona","year":"2012","journal-title":"Fam Process"},{"issue":"6","key":"pone.0318738.ref017","doi-asserted-by":"crossref","first-page":"640","DOI":"10.1007\/s11121-016-0705-9","article-title":"Directions for the Advancement of Culturally Adapted Preventive Interventions: Local Adaptations, Engagement, and Sustainability","volume":"18","author":"Jr Barrera M","year":"2017","journal-title":"Prev Sci"},{"issue":"4","key":"pone.0318738.ref018","doi-asserted-by":"crossref","first-page":"423","DOI":"10.1177\/1049731514535989","article-title":"Cultural Adaptation of Interventions in Real Practice Settings","volume":"25","author":"FF Marsiglia","year":"2015","journal-title":"Res Soc Work Pract"},{"issue":"1","key":"pone.0318738.ref019","doi-asserted-by":"crossref","first-page":"128","DOI":"10.1038\/s41746-021-00498-1","article-title":"Cultural adaptation of internet- and mobile-based interventions for mental disorders: a systematic review","volume":"4","author":"K Spanhel","year":"2021","journal-title":"NPJ Digit Med"},{"issue":"1","key":"pone.0318738.ref020","doi-asserted-by":"crossref","first-page":"24","DOI":"10.1186\/1752-4458-7-24","article-title":"Identification, modification, and implementation of an evidence-based psychotherapy for children in a low-income country: the use of TF-CBT in Zambia","volume":"7","author":"LK Murray","year":"2013","journal-title":"Int J Ment Health Syst"},{"issue":"1","key":"pone.0318738.ref021","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1186\/s13031-021-00391-4","article-title":"Cultural adaptation of a scalable psychological intervention for Burundian refugee adolescents in Tanzania: a qualitative study","volume":"15","author":"A Singh","year":"2021","journal-title":"Confl Health"},{"issue":"1","key":"pone.0318738.ref022","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1186\/s13033-022-00520-3","article-title":"Barriers and facilitators to implementing the HEADSS psychosocial screening tool for adolescents living with HIV\/AIDS in teen club program in Malawi: health care providers perspectives","volume":"16","author":"EC Kip","year":"2022","journal-title":"Int J Ment Health Syst"},{"issue":"1","key":"pone.0318738.ref023","first-page":"3","article-title":"Emergency Department Screening for Adolescent Mental Health Disorders: The Who, What, When, Where, Why, and How It Could and Should Be Done. Clin Pediatr Emerg Med [Internet","volume":"14","author":"TH Chun","year":"2013"},{"issue":"1","key":"pone.0318738.ref024","doi-asserted-by":"crossref","first-page":"278","DOI":"10.1186\/s12887-020-02086-w","article-title":"Experiences and training needs of healthcare providers involved in the care of Ghanaian adolescents living with HIV: an interventional study","volume":"20","author":"A Hayfron-Benjamin","year":"2020","journal-title":"BMC Pediatr"},{"key":"pone.0318738.ref025","author":"World Health Organization, World Organization of Family Doctors","year":"2008"},{"issue":"4","key":"pone.0318738.ref026","doi-asserted-by":"crossref","first-page":"429","DOI":"10.1515\/ijamh-2015-0015","article-title":"Is HEADS in our heads? Health risk behavior is not routinely discussed with young people with chronic conditions","volume":"28","author":"KA Boisen","year":"2016","journal-title":"Int J Adolesc Med Health"},{"issue":"1","key":"pone.0318738.ref027","doi-asserted-by":"crossref","first-page":"683","DOI":"10.1186\/s12913-023-09621-2","article-title":"Psychosocial assessment of adolescents and young adults in paediatric hospital settings: patient and staff perspectives on implementation of the e-HEEADSSS","volume":"23","author":"D Waller","year":"2023","journal-title":"BMC Health Serv Res"},{"key":"pone.0318738.ref028","doi-asserted-by":"crossref","first-page":"1019269","DOI":"10.3389\/fpsyg.2023.1019269","article-title":"Psychosocial wellbeing and risky health behaviors among Syrian adolescent refugees in South Beirut: a study using the HEEADSSS interviewing framework","volume":"14","author":"Y Rizk","year":"2023","journal-title":"Front Psychol"},{"issue":"6","key":"pone.0318738.ref029","doi-asserted-by":"crossref","first-page":"648","DOI":"10.1197\/j.aem.2003.12.022","article-title":"Raising Our HEADSS: Adolescent Psychosocial Documentation in the Emergency Department","volume":"11","author":"LL Van Amstel","year":"2004","journal-title":"Academic Emergency Medicine"},{"key":"pone.0318738.ref030","author":"SK Peifer"},{"issue":"2","key":"pone.0318738.ref031","doi-asserted-by":"crossref","DOI":"10.1542\/peds.2011-3798","article-title":"The HEADS-ED: A Rapid Mental Health Screening Tool for Pediatric Patients in the Emergency Department","volume":"130","author":"M Cappelli","year":"2012","journal-title":"Pediatrics"},{"key":"pone.0318738.ref032","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1186\/s12991-018-0200-8","article-title":"Understanding mental health difficulties and associated psychosocial outcomes in adolescents in the HIV clinic at Kenyatta National Hospital, Kenya","volume":"17","author":"D Gaitho","year":"2018","journal-title":"Ann Gen Psychiatry"},{"key":"pone.0318738.ref033","author":"K Murtagh","year":"2018","journal-title":"G11\u2005The importance of using your headss: introduction of a proforma to improve psychosocial history taking in the emergency department. In: Young People\u2019s Health Special Interest Group"},{"key":"pone.0318738.ref034","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1521\/aeap.2006.18.supp.59","article-title":"Adapting evidence-based behavioral interventions for new settings and target populations","volume":"18","author":"VS McKleroy","year":"2006","journal-title":"AIDS Educ Prev"},{"issue":"6","key":"pone.0318738.ref035","doi-asserted-by":"crossref","first-page":"648","DOI":"10.1197\/j.aem.2003.12.022","article-title":"Raising our HEADSS: adolescent psychosocial documentation in the emergency department","volume":"11","author":"LL Van Amstel","year":"2004","journal-title":"Acad Emerg Med"},{"issue":"4","key":"pone.0318738.ref036","first-page":"249","article-title":"Adolescent Screening, Brief Intervention, and Referral to Treatment for Substance Use: An Application for School Social Workers. Child Sch [Internet","volume":"40","author":"N Singh","year":"2018"},{"issue":"2","key":"pone.0318738.ref037","first-page":"103","article-title":"Assessment of adolescents for depression in the pediatric primary care setting","volume":"36","author":"V Hamrin","year":"2010","journal-title":"Pediatr Nurs"},{"issue":"1","key":"pone.0318738.ref038","doi-asserted-by":"crossref","DOI":"10.1136\/bmjpo-2022-001713","article-title":"Acceptability and usability of a paediatric HIV screening tool in high-volume outpatient settings in Malawi, perspectives from caregivers and healthcare workers","volume":"7","author":"L Katirayi","year":"2023","journal-title":"BMJ Paediatr Open"},{"issue":"5","key":"pone.0318738.ref039","article-title":"Improvement in Adolescent Screening and Counseling Rates for Risk Behaviors and Developmental Tasks. Pediatrics","volume":"130","author":"P Duncan","year":"2012"},{"issue":"8","key":"pone.0318738.ref040","article-title":"Using the HEADSS Assessment to Screen for Adolescent Mental Health Concerns in the Community","volume":"49","year":"2023","journal-title":"Singap Fam Physician"},{"key":"pone.0318738.ref041","doi-asserted-by":"crossref","DOI":"10.1016\/j.destud.2021.101077","article-title":"Sampling in design research: Eight key considerations","volume":"78","author":"P Cash","year":"2022","journal-title":"Des Stud"},{"key":"pone.0318738.ref042","article-title":"Purposive Sampling","author":"O Tajik","year":"2025","journal-title":"Int J Educ Lang Stud"},{"issue":"5","key":"pone.0318738.ref043","doi-asserted-by":"crossref","first-page":"533","DOI":"10.1007\/s10488-013-0528-y","article-title":"Purposeful Sampling for Qualitative Data Collection and Analysis in Mixed Method Implementation Research","volume":"42","author":"LA Palinkas","year":"2013","journal-title":"Adm Policy Ment Health"},{"issue":"4","key":"pone.0318738.ref044","doi-asserted-by":"crossref","first-page":"1893","DOI":"10.1007\/s11135-017-0574-8","article-title":"Saturation in qualitative research: exploring its conceptualization and operationalization","volume":"52","author":"B Saunders","year":"2018","journal-title":"Qual Quant"},{"key":"pone.0318738.ref045","article-title":"Purposeful sampling and saturation in qualitative research methodologies: recommendations and review","author":"RB Bouncken","year":"2025","journal-title":"Rev Manag Sci"},{"issue":"2","key":"pone.0318738.ref046","doi-asserted-by":"crossref","first-page":"199","DOI":"10.1177\/14413582241264619","article-title":"What Is Qualitative Research? An Overview and Guidelines","volume":"33","author":"WM Lim","year":"2024","journal-title":"Australasian Marketing Journal"},{"key":"pone.0318738.ref047","doi-asserted-by":"crossref","first-page":"1512747","DOI":"10.3389\/frma.2024.1512747","article-title":"Participant selection procedures in qualitative research: experiences and some points for consideration","volume":"9","author":"N Dahal","year":"2024","journal-title":"Front Res Metr Anal"},{"issue":"6","key":"pone.0318738.ref048","doi-asserted-by":"crossref","DOI":"10.1136\/jech.2006.048819","article-title":"Handbook for good clinical research practice (GCP): guidance for implementation","volume":"61","author":"A Barton","year":"2007","journal-title":"J Epidemiol Community Health"},{"key":"pone.0318738.ref049","first-page":"132","volume-title":"Handbook for good clinical research practice (GCP): guidance for implementation","author":"Weltgesundheitsorganisation","year":"2005"},{"key":"pone.0318738.ref050","article-title":"Government of the Republic of Malawi. National Commission for Science and Technology. National policy measures and requirements for the improvement of health research co-ordination in Malawi. 2012 revised edition"},{"issue":"4","key":"pone.0318738.ref051","first-page":"311","article-title":"A Heuristic Framework for the Cultural Adaptation of Interventions","volume":"13","author":"M Barrera","year":"2006","journal-title":"Clinical Psychology: Science and Practice"},{"issue":"1","key":"pone.0318738.ref052","first-page":"6","article-title":"Culturally adapting a physical activity intervention for Somali women: the need for theory and innovation to promote equity. Transl Behav Med [Internet","volume":"7","author":"KE Murray","year":"2017"},{"issue":"4","key":"pone.0318738.ref053","first-page":"295","article-title":"Making the Case for Selective and Directed Cultural Adaptations of Evidence-Based Treatments: Examples From Parent Training","volume":"13","author":"AS Lau","year":"2006","journal-title":"Clinical Psychology: Science and Practice"},{"issue":"4","key":"pone.0318738.ref054","doi-asserted-by":"crossref","first-page":"589","DOI":"10.1080\/2159676X.2019.1628806","article-title":"Reflecting on reflexive thematic analysis","volume":"11","author":"V Braun","year":"2019","journal-title":"Qualitative Research in Sport, Exercise and Health"},{"key":"pone.0318738.ref055","doi-asserted-by":"crossref","DOI":"10.1177\/16094069241236603","article-title":"Reflexive Content Analysis: An Approach to Qualitative Data Analysis, Reduction, and Description","volume":"23","author":"M Nicmanis","year":"2024","journal-title":"International Journal of Qualitative Methods"},{"key":"pone.0318738.ref056","doi-asserted-by":"crossref","DOI":"10.46743\/2160-3715\/2021.5010","article-title":"Reflexive Thematic Analysis for Applied Qualitative Health Research.","author":"K Campbell","year":"2021"},{"key":"pone.0318738.ref057","doi-asserted-by":"crossref","DOI":"10.4135\/9781529601923","volume-title":"Reflexive Thematic Analysis in Story Completion Research [Internet]. 1 Oliver\u2019s Yard, 55 City Road, London EC1Y 1SP","author":"C Lenette","year":"2022"},{"issue":"2","key":"pone.0318738.ref058","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1191\/1478088706qp063oa","article-title":"Using thematic analysis in psychology","volume":"3","author":"V Braun","year":"2006","journal-title":"Qualitative Research in Psychology"},{"issue":"8","key":"pone.0318738.ref059","doi-asserted-by":"crossref","first-page":"846","DOI":"10.1080\/0142159X.2020.1755030","article-title":"Thematic analysis of qualitative data: AMEE Guide No. 131","author":"ME Kiger","year":"2020","journal-title":"Med Teach"},{"issue":"1","key":"pone.0318738.ref060","doi-asserted-by":"crossref","DOI":"10.15412\/J.JCC.02010107","article-title":"Understanding Thematic Analysis and its Pitfall.","volume":"1","author":"M Javadi","year":"2016","journal-title":"J Client Care"},{"issue":"1","key":"pone.0318738.ref061","doi-asserted-by":"crossref","DOI":"10.1177\/1609406917733847","article-title":"Thematic Analysis","volume":"16","author":"LS Nowell","year":"2017","journal-title":"International Journal of Qualitative Methods"},{"issue":"1","key":"pone.0318738.ref062","first-page":"31","article-title":"Triangulation and Trustworthiness \u2014Advancing Research on Public Service Interpreting through Qualitative Case Study Methodologies. FITISPos Int J [Internet","volume":"7","author":"Solano Aguilar","year":"2020"},{"issue":"4","key":"pone.0318738.ref063","doi-asserted-by":"crossref","first-page":"532","DOI":"10.1177\/1363461513502697","article-title":"Strategies for assessing mental health in Haiti: local instrument development and transcultural translation","volume":"50","author":"BN Kaiser","year":"2013","journal-title":"Transcult Psychiatry"},{"issue":"1","key":"pone.0318738.ref064","doi-asserted-by":"crossref","first-page":"141","DOI":"10.1007\/s10461-023-04137-6","article-title":"Identifying Adolescents at Highest Risk of ART Non-adherence, Using the World Health Organization-Endorsed HEADSS and HEADSS+\u2009Checklists","volume":"28","author":"LD Cluver","year":"2023","journal-title":"AIDS Behav"},{"issue":"2","key":"pone.0318738.ref065","first-page":"145","article-title":"Screening and Assessing Suicide Risk in Medical Settings: Feasible Strategies for Early Detection","volume":"21","author":"LM Horowitz","year":"2023","journal-title":"Focus (Am Psychiatr Publ)"},{"issue":"16","key":"pone.0318738.ref066","doi-asserted-by":"crossref","first-page":"3361","DOI":"10.1017\/S0033291714001299","article-title":"Does asking about suicide and related behaviours induce suicidal ideation? What is the evidence?","volume":"44","author":"T Dazzi","year":"2014","journal-title":"Psychol Med"},{"key":"pone.0318738.ref067","first-page":"29768357251327567","article-title":"Suicidal Ideation and Attempts Among Youth Living With HIV\/AIDS Attending Botswana-Baylor Children\u2019s Clinical Centre of Excellence: A Comparison Between Substance Users and Non-Substance Users","volume":"19","author":"L Baghirova-Busang","year":"2025","journal-title":"Subst Use"},{"issue":"2","key":"pone.0318738.ref068","first-page":"145","article-title":"Screening and Assessing Suicide Risk in Medical Settings: Feasible Strategies for Early Detection","volume":"21","author":"LM Horowitz","year":"2023","journal-title":"Focus (Am Psychiatr Publ)"},{"issue":"13","key":"pone.0318738.ref069","doi-asserted-by":"crossref","first-page":"1635","DOI":"10.1001\/jama.293.13.1635","article-title":"Evaluating iatrogenic risk of youth suicide screening programs: a randomized controlled trial","volume":"293","author":"MS Gould","year":"2005","journal-title":"JAMA"},{"issue":"1","key":"pone.0318738.ref070","doi-asserted-by":"crossref","first-page":"122","DOI":"10.1186\/s12888-017-1212-7","article-title":"How do healthcare professionals interview patients to assess suicide risk?","volume":"17","author":"R McCabe","year":"2017","journal-title":"BMC Psychiatry"},{"issue":"5","key":"pone.0318738.ref071","doi-asserted-by":"crossref","first-page":"379","DOI":"10.1192\/bjp.bp.110.083592","article-title":"Impact of screening for risk of suicide: randomised controlled trial","volume":"198","author":"MJ Crawford","year":"2011","journal-title":"Br J Psychiatry"},{"key":"pone.0318738.ref072","author":"R W\u00e4rdig","year":"2022"},{"issue":"16","key":"pone.0318738.ref073","first-page":"3361","article-title":"Does asking about suicide and related behaviours induce suicidal ideation? What is the evidence? Psychol Med [Internet","volume":"44","author":"T Dazzi","year":"2014"},{"issue":"3","key":"pone.0318738.ref074","doi-asserted-by":"crossref","first-page":"356","DOI":"10.1016\/j.jad.2012.08.024","article-title":"Qualitative interviewing with vulnerable populations: individuals\u2019 experiences of participating in suicide and self-harm based research","volume":"145","author":"L Biddle","year":"2013","journal-title":"J Affect Disord"},{"issue":"16","key":"pone.0318738.ref075","first-page":"3409","article-title":"The ethics of doing nothing. Suicide-bereavement and research: ethical and methodological considerations. Psychol Med [Internet","volume":"44","author":"P Omerov","year":"2014"},{"issue":"1","key":"pone.0318738.ref076","doi-asserted-by":"crossref","first-page":"1413","DOI":"10.1186\/s12913-023-10344-7","article-title":"Improving integrated depression and non-communicable disease care in Malawi through engaged leadership and supportive implementation climate","volume":"23","author":"GM Sansbury","year":"2023","journal-title":"BMC Health Serv Res"},{"key":"pone.0318738.ref077","first-page":"4610458","article-title":"Prevalence of Depressive Symptoms and Associated Factors among HIV-Positive Youth Attending ART Follow-Up in Addis Ababa, Ethiopia","volume":"2019","author":"H Abebe","year":"2019","journal-title":"AIDS Res Treat"},{"issue":"1","key":"pone.0318738.ref078","doi-asserted-by":"crossref","first-page":"38","DOI":"10.1186\/s12981-024-00628-1","article-title":"Depression symptoms and suicidal ideation among HIV infected Rwandans: the mediating and moderating effects of complicated grief and substance abuse","volume":"21","author":"A Uwiringiyimana","year":"2024","journal-title":"AIDS Res Ther"},{"issue":"4","key":"pone.0318738.ref079","doi-asserted-by":"crossref","first-page":"273","DOI":"10.5114\/hivar.2019.85949","article-title":"Prevalence and psychosocial correlates of suicidal ideation among adolescents living with HIV in Southwestern Nigeria, West Africa","volume":"18","author":"S Adeyemo","year":"2019","journal-title":"HIV & AIDS Review"},{"key":"pone.0318738.ref080","author":"E Gamassa","year":"2023"},{"key":"pone.0318738.ref081","article-title":"Prevalence and Factors Associated With Suicidal Ideation Among Children and Adolescents Attending a Pediatric HIV Clinic in Uganda. Front Sociol [Internet","volume":"6","author":"JD Namuli","year":"2021"},{"key":"pone.0318738.ref082","author":"M Udedi","year":"2016"},{"key":"pone.0318738.ref083","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1186\/s13033-017-0169-8","article-title":"Mental health training for primary health care workers and implication for success of integration of mental health into primary care: evaluation of effect on knowledge, attitude and practices (KAP)","volume":"11","author":"G Ayano","year":"2017","journal-title":"Int J Ment Health Syst"},{"key":"pone.0318738.ref084","article-title":"Healthcare providers\u2019 knowledge and use of psychological and psychoSOCIAL screening and interventions in the management of patients with tendinopathy: An International Survey of Practice","author":"S O\u2019Neill","year":"2024","journal-title":"Cold Spring Harbor Laboratory"},{"issue":"1","key":"pone.0318738.ref085","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1186\/s13033-020-0337-0","article-title":"Evaluation of mhGAP training for primary healthcare workers in Mulanje, Malawi: a quasi-experimental and time series study","volume":"14","author":"D Kokota","year":"2020","journal-title":"Int J Ment Health Syst"},{"key":"pone.0318738.ref086","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1186\/s13033-020-00345-y","article-title":"Implementing an mhGAP-based training and supervision package to improve healthcare workers\u2019 competencies and access to mental health care in Malawi","volume":"14","author":"J Ahrens","year":"2020","journal-title":"Int J Ment Health Syst"},{"key":"pone.0318738.ref087","doi-asserted-by":"crossref","first-page":"31735","DOI":"10.3402\/gha.v9.31735","article-title":"Evaluation of a training program for health care workers to improve the quality of care for rape survivors: a quasi-experimental design study in Morogoro, Tanzania","volume":"9","author":"M Abeid","year":"2016","journal-title":"Glob Health Action"},{"issue":"3","key":"pone.0318738.ref088","first-page":"657","article-title":"Training primary health care workers in mental health and its impact on diagnoses of common mental disorders in primary care of a developing country, Malawi: a cluster-randomized controlled trial. Psychol Med [Internet","volume":"44","author":"F Kauye","year":"2014"},{"issue":"4","key":"pone.0318738.ref089","doi-asserted-by":"crossref","first-page":"260","DOI":"10.1177\/070674370905400407","article-title":"Gatekeeper training as a preventative intervention for suicide: a systematic review","volume":"54","author":"M Isaac","year":"2009","journal-title":"Can J Psychiatry"}],"container-title":["PLOS One"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0318738","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,17]],"date-time":"2025-11-17T18:34:47Z","timestamp":1763404487000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0318738"}},"subtitle":[],"editor":[{"given":"Anthony A.","family":"Olashore","sequence":"first","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2025,11,17]]},"references-count":89,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2025,11,17]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0318738","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,11,17]]}}}