Addressing Mental Health to Improve Adolescents’ Adherence to ART

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Senior lecturer at the University of Botswana, Dr Anthony Olashore was overjoyed to graduate with his PhD in Psychiatry.

His study, which explored the impact of psychological interventions on mental health and anti-retroviral therapy (ART) adherence among mentally-ill adolescents living with HIV (ALWHIV) in Botswana, was co-supervised by the Head of Psychiatry at UKZN, Professor Bonginkosi Chiliza and the Discipline’s Professor Saeeda Paruk.

‘This is a major milestone. I am confident that I can accomplish anything by focusing my mind. My next goal is to secure a National Institutes of Health grant, broaden the scope of my project, and establish myself as a highly regarded academic professor,’ he said. 

Olashore compared a cohort of ALWHIV that was infected from birth with one that contracted HIV later in life. He noted that HIV-positive African children and adolescents may suffer from depression and cognitive impairment and that addressing mental health issues could improve treatment adherence and reduce new infections in countries like Botswana, where a third of new infections occur among adolescents. This would benefit society at large as well as the individuals concerned. 

The study found that many ALWHIV struggle with treatment adherence, with depression being the main related disorder. Olashore developed a short psychological intervention that was tested and found to be effective. ‘This has important implications for cost-effective treatment approaches in resource-constrained settings like Botswana and may effectively reduce the high rate of HIV spread,’ he said. The findings suggest the need to do away with the one-size-fits-all approach adopted in many African settings, as adolescents have different psychosocial needs, calling for tailored approaches to improve their mental health care. ‘More importantly, the results reiterate the need to consider the mode of infection when providing care to ALWHIV in this setting,’ said Olashore. 

He added that he has been drawn to working with often overlooked or marginalised adolescents throughout his career. 

‘My master’s dissertation focused on adolescents who found themselves in conflict with the law or were deemed beyond parental control. I hoped to continue this work at PhD level but found it challenging to conduct research on this population in Botswana. As a result, I shifted my focus to those living with HIV. This group accounts for more than 30% of new infections and has been under-researched, making it a crucial study area.’ 

COVID-19 and being a foreigner in Botswana did not deter Olashore. ‘I had a fantastic time at UKZN, mainly due to the outstanding facilities provided. The software is state-of-the-art, and the team was incredibly supportive. They were very concerned about my well-being, including my mental health during the pandemic. Professors Chiliza and Paruk, my supervisors, were more than just mentors; they were also my friends who went the extra mile to ensure I completed the programme on time. The study environment was stimulating and welcoming, with helpful staff who made my experience even more enjoyable.’ 

Born in the rural town of Ijebu Igbo in Ogun State, Nigeria, Olashore’s family worked as public servants. Education was not a choice but a must, as it was the only legacy within their grasp. ‘In Nigeria, where everything, including education, comes at a cost, and with fierce competition and limited resources, failure was not an option. This drove me to cultivate a relentless work ethic and to make sacrifices to achieve my goals. Through unwavering determination, I completed my medical studies without any hiccups.’ 

‘I am especially proud that Anthony completed a clinical study despite the COVID-19 pandemic. Botswana had very strict lockdown laws and he had to make serious adjustments that took a few iterations to get right. He did all of this despite being a foreigner in Botswana with threats to the longevity of his contract in the background,’ said Chiliza. 

Olashore published six peer-reviewed articles from his study, as well as other peer-reviewed articles from another study on adolescents and an editorial. 

In his spare time, he enjoys spending quality time with friends, jogging to stay fit, listening to soulful music, playing the piano, indulging in some light reading and cooking up a storm in the kitchen. 

Words: Lunga Memela

Photograph: Sethu Dlamini