Randomized Clinical Trial of Cognitive Behavioral Stress Management on Human Immunodeficiency Virus Viral Load in Gay Men Treated With Highly Active Antiretroviral Therapy

Antoni, Mike; Carrico, Adam W.; Durán, Ron E.; Spitzer, Susan B.; Penedo, Frank J.; Ironson, Gail; Fletcher, Mary A; Klimas, Nancy G.; Schneiderman, Neil

doi:10.1097/01.psy.0000195749.60049.63

Cited by 145 publications

(150 citation statements)

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“…To the extent that positive spiritual reframing may be viewed as related to cognitive restructuring, our result is consistent with a prior study showing that this skill taught as a part of a stress management intervention in HIV predicted better viral load control. 24 Also potentially relevant to our understanding of this novel result, finding meaning in the loss of a partner predicted lower rates of AIDS-related mortality. 25 Finding meaning was also linked to lower 5-year mortality in HIV-seropositive women in conjunction with positive affect 1 Positive spiritual coping is a dichotomous variable that was created based on the nine-item scale of spiritual coping by contrasting participants who exhibited positive coping (+2 to +4) to all other participants (−4 to +1) N = 176; † p < 0.10; * p < 0.05; ** p < 0.01; *** p < 0.001; Models controlled for CD4 and VL at baseline, age, gender, education, ethnicity, sexual orientation The base model controlled for CD4 and VL at baseline, gender, age, education, ethnicity, sexual orientation.…”

Section: Discussionmentioning

confidence: 99%

Relationship Between Spiritual Coping and Survival in Patients with HIV

2016

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BACKGROUND: Studies of spirituality in initially healthy people have shown a survival advantage, yet there are fewer research studies in the medically ill, despite the widespread use of spirituality/religiousness to cope with serious physical illness. In addition, many studies have used limited measures such as religious service attendance. OBJECTIVE: We aimed to examine if, independent of medication adherence, the use of spirituality/religiousness to cope with HIV predicts survival over 17 years. DESIGN: This was a longitudinal study, started in 1997. Study materials were administered semi annually. PARTICIPANTS: A diverse sample of 177 HIV patients initially in the mid-stage of disease (150-500 CD4-cells/ mm 3 ; no prior AIDS-defining symptoms) participated in the study. MAIN MEASURES: Participants were administered a battery of psychosocial questionnaires and a blood draw. They completed interviews and essays to assess current stressors. Spiritual coping (overall/strategies) was rated by qualitative content analysis of interviews regarding stress and coping with HIV, and essays. KEY RESULTS: Controlling for medical variables (baseline CD4/viral load) and demographics, Cox regression analyses showed that overall positive spiritual coping significantly predicted greater survival over 17 years (mortality HR = 0.56, p = 0.039). Findings held even after controlling for health behaviors (medication adherence, substance use) and social support. Particular spiritual coping strategies that predicted longer survival included spiritual practices (HR = 0.26, p < 0.001), spiritual reframing (HR = 0.27, p = 0.006), overcoming spiritual guilt (HR = 0.24, p < 0.001), spiritual gratitude (HR = 0.40, p = 0.002), and spiritual empowerment (HR = 0.52, p = 0.024), indicating that people using these strategies were 2-4 times more likely to survive. CONCLUSIONS: To our knowledge this is the first study showing a prospective relationship of spiritual coping in people who are medically ill with survival over such a long period of time, and also specifically identifies several strategies of spirituality that may be beneficial.

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Section: Discussionmentioning

confidence: 99%

Relationship Between Spiritual Coping and Survival in Patients with HIV

2016

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“…86 A third study compared a 10-week CBSM intervention supplemented with four brief medication adherence training sessions delivered by a pharmacist to a medication adherence training only group. 87 There were no differences in viral load between the two groups; however, PLWHA in the intervention condition who had a detectable viral load at baseline had decreased viral load relative to the medication adherence training only group. 87 Additionally, decreases in depressed mood among the intervention group participants explained the decreased viral load across the 15-month follow-up period.…”

Section: Stress Management Combined With Health Behavior Change Adhermentioning

confidence: 78%

“…87 There were no differences in viral load between the two groups; however, PLWHA in the intervention condition who had a detectable viral load at baseline had decreased viral load relative to the medication adherence training only group. 87 Additionally, decreases in depressed mood among the intervention group participants explained the decreased viral load across the 15-month follow-up period. 87 …”

Section: Stress Management Combined With Health Behavior Change Adhermentioning

confidence: 78%

Stress management interventions for HIV-infected individuals: review of recent intervention approaches and directions for future research

Brown¹,

Vanable²

2011

NBHIV

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To promote psychological wellbeing and adaptive coping among people living with human immunodeficiency virus/acquired immune deficiency syndrome (PLWHA), a number of stress management interventions have been designed and evaluated. This paper reviews recent stress management intervention approaches designed to improve the coping skills of PLWHA and reduce psychological distress. First, a summary of findings from previous narrative reviews and meta-analyses of the stress management intervention literature for PLWHA is provided. Next, recent stress management interventions for PLWHA that fall into one of four categories are reviewed: (a) interventions to improve coping and modify other health behaviors (ie, highly active antiretroviral medication adherence, sexual behaviors), (b) meditation, mindfulness, and relaxation-based stress management approaches, (c) computer-delivered interventions, and (d) interventions that target specific populations including older individuals, individuals with childhood sexual abuse histories, and women. A critique of recent stress management interventions for PLWHA is provided as well as directions for future research.

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“…disease-related outcomes, mood and functioning [27][28][29][30][31][32][33]. Pending evidence from similar trials with CKD and CKD5 patients, renal practitioners seeking to provide optimal care may want to consider the impact of stressful life events on patients, whether or not these events are related to kidney disease.…”

Section: Event-related Distress In Kidney Disease Patientsmentioning

confidence: 99%

167: Event-Related Distress in Kidney Disease Patients

2009

American Journal of Kidney Diseases

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Background. Non-dialysis-dependent chronic kidney disease (CKD) and dialysis-dependent Stage 5 CKD (CKD5) are associated with a significant physical and psychosocial burden. Little is known, however, about the impact of stressful life events on CKD and CKD5 patients. This study aimed to determine the prevalence of stressful life events in CKD and CKD5 patients and identify the factors correlated with high levels of event-related distress. Methods. This cross-sectional study's sample consisted of 181 patients (91 with non-dialysis-dependent CKD Stages 4 and 5, 90 with CKD5) who filled out the Impact of Event Scale (IES), which measures subjective distress related to stressful life events. Other measures included scores from the Medical Outcomes Study Short Form-36, Patient Health Questionnaire-9 (PHQ-9) and Dialysis Symptom Index (DSI). Results. One hundred and three subjects reported stressors on the IES. Almost half the stressors (49.5%) related to personal health; the rest fell into other categories. There were significant differences between the no stressor, low event-related distress and high event-related distress groups in age (P < 0.001), PHQ-9 score (P < 0.001) and DSI score (P ¼ 0.002). After adjustment, PHQ-9 score was associated with high event-related distress [odds ratio (OR) 1.20, 95% confidence interval (CI) 1.10-1.32], as was DSI score (OR 1.04, 95% CI 1.02-1.07) in a separate model. Conclusions. Event-related distress is common in CKD and CKD5 patients. High event-related distress is associated with worse depressive symptoms and greater somatic and emotional symptom burden, even with adjustments for age and gender. The renal practitioner may need to address patients' event-related distress in order to provide optimal care.

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Randomized Clinical Trial of Cognitive Behavioral Stress Management on Human Immunodeficiency Virus Viral Load in Gay Men Treated With Highly Active Antiretroviral Therapy

Abstract: A time-limited CBSM + MAT intervention that modulates depressed mood may enhance the effects of HAART on suppression of HIV viral load in HIV+ men with detectable plasma levels.

Cited by 145 publications

References 40 publications

Relationship Between Spiritual Coping and Survival in Patients with HIV

Relationship Between Spiritual Coping and Survival in Patients with HIV

Stress management interventions for HIV-infected individuals: review of recent intervention approaches and directions for future research

167: Event-Related Distress in Kidney Disease Patients

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