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February 19, 2026AIDS and Behavior0 citationsOpen Access

Acceptability of an Integrated Model of Mental Health and PrEP Service Delivery for South African Adolescent Girls: Qualitative Results from a Pilot Hybrid Effectiveness-Implementation Randomized Trial

LMLisa MillsSDS. Delany-MoretlweMNMakhosazane Nomhle Ndimande-Khoza

Key Points

  • This research aims to evaluate the acceptability of an integrated approach to mental health and PrEP services for adolescent girls and young women in South Africa.
  • Conducted a pilot hybrid effectiveness-implementation randomized trial from April 2023 to February 2024.
  • Randomized 116 AGYW aged 18-25 with common mental disorder symptoms to receive either Youth Friendship Bench plus standard care or standard care alone.
  • Conducted in-depth interviews with 30 AGYW and 13 staff and key informants to gather qualitative data.
  • AGYW found the Youth Friendship Bench intervention highly acceptable, appreciating its confidentiality and empowerment.
  • Participants recognized the benefits of CMD screening but faced low referral uptake due to various barriers.
  • Integrated services combining mental health support and PrEP delivery were viewed positively by the AGYW.

Abstract

Abstract Adolescent girls and young women (AGYW) at elevated HIV risk often experience common mental disorders (CMD), which are linked to lower PrEP adherence. We piloted a CMD intervention, the Youth Friendship Bench SA (YFB), and delivered alongside PrEP to improve CMD symptoms and PrEP adherence among South African AGYW. From April 2023-February 2024, 116 AGYW (18–25 years) with CMD symptoms were randomized to YFB plus standard of care (SOC) or SOC alone and followed for 12 weeks. In-depth interviews were conducted with 30 AGYW and 13 study staff and key informants. CMD screening alone was seen as beneficial, but referral uptake was low due to perceived severity thresholds, staff attitudes, and logistical barriers. YFB was highly acceptable to AGYW, who valued the intervention for being confidential, informal, and empowering. Integrated CMD and PrEP services were acceptable, and lay counsellor delivery shows promise for addressing the mental health care gap.

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Cite This Study

Mills et al. (2026) studied this question.

synapsesocial.com/papers/6996a7ffecb39a600b3ee3ffhttps://doi.org/10.1007/s10461-025-05007-z
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