The Efficacy of Group Teletherapy-Delivered Cognitive Behavioural Therapy for Depression in People Living with HIV: A Systematic Review of the African Evidence

Depression is a prevalent comorbidity among people living with HIV (PLWH) in Africa, adversely affecting treatment adherence and quality of life. While cognitive behavioural therapy (CBT) is an established treatment, access remains limited. Group teletherapy could potentially improve access, but its efficacy within African healthcare contexts is not well established. This systematic review aimed to synthesise the evidence on the efficacy of group teletherapy-delivered CBT for depression among PLWH in Africa. The primary objective was to determine its impact on reducing depressive symptoms. A systematic search was conducted across multiple electronic databases. Eligible studies were randomised controlled trials (RCTs) conducted in Africa, evaluating group teletherapy CBT for depression in PLWH. Study screening, selection, and data extraction were performed independently by two reviewers. The Cochrane risk of bias tool was used for quality assessment. No RCTs meeting all inclusion criteria were identified. The search revealed a significant gap in primary research on this specific intervention within Africa. The available literature consisted of study protocols, pilot feasibility studies, and trials of in-person or individual therapy, indicating this is a nascent field of enquiry. There is a critical absence of robust evidence from RCTs on the efficacy of group teletherapy-delivered CBT for depression in PLWH in Africa. This highlights a major research gap, despite the intervention's potential to address a significant public health need. Priority should be given to funding and conducting well-designed RCTs of group teletherapy CBT in diverse African settings. Future research must consider cultural adaptation, technological accessibility, and integration within existing HIV care systems. teletherapy, cognitive behavioural therapy, depression, HIV, Africa, systematic review, group therapy This review identifies and underscores a specific evidence gap in a promising area of digital mental health intervention for a key population in Africa, providing clear direction for future primary research.