Brief Cognitive Behavior Therapy for Stigmatization, Depression, Quality of life, social support and Adherence to Treatment among Patients with HIV/AIDS: A Randomized Control Trial

Abstract

Objective: Individuals living with HIV/AIDs are at high risk of mental health problems, particularly depression, stigma, quality of life, adherence to treatment, and lack of social support. The present study aimed to investigate the impact of brief-cognitive behavior therapy (B-CBT) on reducing depression and stigma and improving treatment adherence, quality of life, and social support among patients with HIV/AIDS attending antiretroviral therapy (ART). Materials and Methods: This randomized clinical trial was conducted at ART Clinic in the Tehsil Headquarters Hospital Shahkot Nankana Sahib from July 2021 to October 2021. After baseline screening, 126 patients met the eligibility criteria and were allocated to the experimental group (EXPg=63) and waitlist-control group (WLCg=63). Participants’ age range was 20 to 55 years. Participants attending ART treatment were enrolled for the CBT treatment. Before this, all the participants completed a baseline assessment to ensure a level of severity and diagnosis. A total of eight therapeutic sessions based on CBT were conducted individually with EXPg. To assess the outcomes among patients receiving ART, we used the i.e., Demographic form, Patient health questionnaire, HIV stigma scale, General medication adherence scale, Multidimensional scale of perceived social support, and WHOQOL BREF scale. Results: Findings reported B-CBT significantly reduced the level of depression (i.e. F (1, 78) = 101.38, p<.000, η2= .599), and social stigma (i.e. F (1, 78) = 208.47, p<.000, η2= .787) among patients with HIV/AIDS. Furthermore, CBT substantially improved the level of adherence to treatment (i.e. F(1,78)= 24.75, p<.000, η2= .503), social support (i.e. F (1, 78) = 128.33, p<.000, η2= .606), and quality of life (i.e. F (1, 78) = 373.39, p<.000, η2= .837) among patients with HIV/AIDS. Significant mean difference M(SD) on PHQ at post-analysis in the EXPg vs. WLC was seen 1.22(0.47) vs. 2.30(0.68) and similarly, on MPSS at a post-analysis in the EXPg vs. WLC 2.85(0.36) vs. 1.70(0.51) which indicates sound therapeutic outcomes. Conclusions: Cognitive behavioral therapy effectively decreases the level of depression and stigma and enhances the level of social support, quality of life, and adherence to treatment among HIV/AIDS patients. It is concluded that cognitive behavior therapy is an effective treatment approach for patients with HIV/AIDS. Trial Registration: Thai clinical trial registry (i.e. TCTR= TCTR20210702002, with URL: https://www.thaiclinicaltrials.org/show/TCTR20210702002).