Impact of COVID-19 on the implementation of mental health interventions for adolescents living with HIV in sub-Saharan Africa: a systematic review protocol.

INTRODUCTION

Adolescents living with HIV (ALHIV) in sub-Saharan Africa (SSA) are a vulnerable population disproportionately affected by mental health disorders due to the combined burden of chronic illness, stigma and socioeconomic challenges. In response, numerous mental health interventions have been implemented to support ALHIV. However, the COVID-19 pandemic significantly disrupted health systems, particularly in-person services, potentially undermining the delivery and efficacy of these interventions. This protocol describes the methodology for a systematic review that will assess the impact of the COVID-19 pandemic on the implementation of mental health interventions for ALHIV in SSA and to explore the emergence or adaptation of interventions during this period.

METHODS AND ANALYSIS: Data will be collected, analysed and reported per the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We will search PubMed, Web of Science, APA PsycINFO and Scopus for literature published from 2020 to 2025. Eligible studies will include both qualitative and quantitative designs that assess mental health interventions for ALHIV in SSA or explore pandemic-related implementation impacts. Both peer-reviewed and grey literature will be included. The primary outcomes of interest are implementation-related outcomes, including service disruptions, adaptations, feasibility, acceptability and barriers or facilitators influencing intervention delivery during the COVID-19 pandemic. Data, including study design, methodology and results, will be extracted and synthesised using an Excel spreadsheet. Specific inclusion and exclusion criteria will be used during literature screening and will include study type, location and language.

ETHICS AND DISSEMINATION: This review uses only publicly accessible data from previously published studies and does not involve the collection of primary data or identifiable human subjects. Therefore, ethical approval is not required. The results of the review will be disseminated through publication in a peer-reviewed journal and shared with stakeholders working in adolescent HIV and mental health services in SSA.

PROSPERO REGISTRATION NUMBER: CRD420251147822.