A randomized controlled trial of cognitive behavioral therapy for adherence and depression (CBT-AD) in HIV-infected individuals.

Bibliographic Data

ID23378747
AuthorsSteven A Safren (0000-0002-0121-0806, Harvard University), Conall O’cleirigh (0000-0002-5639-5043, Harvard University), Judy Y Tan (0000-0003-4414-1035, Fenway Health), Sudha Raminani (Fenway Health), Sudha R Raminani, Laura C Reilly (Massachusetts General Hospital), Michael W Otto (0000-0002-8915-7578, Boston University), Kenneth H Mayer (0000-0001-7460-733X, Fenway Health)
Year2009
Volume28
Issue1
Pages1-10
Publication date2009-01-01
Peer ReviewedYes
Open AccessNo
TypeARTICLE
VenueHealth Psychology (JOURNAL)
Journal identifiersISSN: 0278-6133 • E-ISSN: 1930-7810
PublisherAmerican Psychological Association (APA) (PUBLISHER)
DOI10.1037/a0012715
PMID19210012
PMCIDPMC2643364
OpenAlexW2094622809
LanguageEN
Citations received98
References cited24

OBJECTIVE: To evaluate cognitive-behavioral therapy to enhance medication adherence and reduce depression (CBT-AD) in individuals with HIV. DESIGN: A two arm, randomized, controlled, cross-over trial comparing CBT-AD to enhanced treatment as usual only (ETAU). ETAU, which both groups received, included a single-session intervention for adherence and a letter to the patient's provider documenting her or his continued depression. The intervention group also received 10 to 12 sessions of CBT-AD. MAIN OUTCOME MEASURES: Adherence to antiretroviral therapy as assessed by Medication Event Monitoring Systems (MEMs) and depression as assessed by blinded structured evaluation. RESULTS: At the acute outcome assessment (3-months), those who received CBT-AD evidenced significantly greater improvements in medication adherence and depression relative to the comparison group. Those who were originally assigned to the comparison group who chose to cross over to CBT-AD showed similar improvements in both depression and adherence outcomes. Treatment gains for those in the intervention group were generally maintained at 6- and 12-month follow-up assessments. By the end of the follow-up period, those originally assigned CBT-AD demonstrated improvements in plasma HIV RNA concentrations, though these differences did not emerge before the cross-over, and hence there were not between-groups differences. CONCLUSIONS: CBT-AD is a potentially efficacious approach for individuals with HIV struggling with depression and adherence. Replication and extension in larger efficacy trials are needed.

Cognitive behavioral therapy · Cognitive therapy · Depression (economics) · Intervention (counseling) · Physical therapy · Psychiatry · Randomized controlled trial · Biological Research and Disease Studies · Clinical Psychology · HIV-related health complications and treatments · HIV/AIDS Research and Interventions · Internal Medicine · Medicine