The Effect of the Shikamana Peer-and-Provider Intervention on Depressive Symptoms, Alcohol Use, and Other Drug Use among Gay, Bisexual, and Other Men Who Have Sex with Men (GBMSM) in Kenya
Bibliographic record
Abstract
Kenyan gay, bisexual, and other men who have sex with men (GBMSM) face unique stigma and discrimination, which may contribute to adverse mental health symptoms, and could limit antiretroviral therapy (ART) adherence among GBMSM living with HIV.This secondary analysis of data from a randomized pilot study evaluated whether the Shikamana peer-and-provider intervention was associated with changes in psychosocial factors over time.Psychosocial measures were taken at three quarterly study visits by audio computer-assisted self-interview (ACASI).Generalized estimating equations (GEE) were used to evaluate whether rates of change in depressive symptom severity, alcohol use, or other drug use differed by allocation group.We used linear regression to further examine when these differences were observed and to identify other predictors of changes in depressive symptoms.At baseline, both groups were comparable, but the intervention group reported greater depressive symptomatology on average (p=0.09).The intervention was associated with a 1.6 point greater (95% CI: 0.2 -3.1 points) reduction in depressive symptoms per visit over the 6-month period compared to the standard of care.There were no significant changes in scores for other psychosocial factors.In an exploratory analysis, baseline HIV stigma was associated with greater reductions in depressive symptoms.For each one-point increase in baseline HIV stigma in the intervention group, participants had a 0.12-point (95% CI: 0.02 -0.23 points) monthly reduction in depressive symptoms.We found that the Shikamana intervention was associated with a reduction in depressive symptoms, and baseline HIV stigma may predict response to the intervention to some extent.Additional research is required to understand factors that influence this peer-and-provider intervention's effects and whether depressive symptoms, stigma, or other psychosocial factors could be affected in a larger trial.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.002 | 0.001 |
| Scholarly communication | 0.000 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.007 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".