ERIC Number: EJ992305
Record Type: Journal
Publication Date: 2012-Jun
Pages: 12
Abstractor: As Provided
ISBN: N/A
ISSN: ISSN-0022-006X
EISSN: N/A
Cognitive Behavioral Therapy for Adherence and Depression (CBT-AD) in HIV-Infected Injection Drug Users: A Randomized Controlled Trial
Safren, Steven A.; O'Cleirigh, Conall M.; Bullis, Jacqueline R.; Otto, Michael W.; Stein, Michael D.; Pollack, Mark H.
Journal of Consulting and Clinical Psychology, v80 n3 p404-415 Jun 2012
Objective: Depression and substance use, the most common comorbidities with HIV, are both associated with poor treatment adherence. Injection drug users comprise a substantial portion of individuals with HIV in the United States and globally. The present study tested cognitive behavioral therapy for adherence and depression (CBT-AD) in patients with HIV and depression in active substance abuse treatment for injection drug use. Method: This is a 2-arm, randomized controlled trial (N = 89) comparing CBT-AD with enhanced treatment as usual (ETAU). Analyses were conducted for two time-frames: (a) baseline to post-treatment and (b) post-treatment to follow-up at 3 and 6 months after intervention discontinuation. Results: At post-treatment, the CBT-AD condition showed significantly greater improvement than ETAU in MEMS (electronic pill cap) based adherence, gamma[subscript slope] = 0.8873, t(86) = 2.38, p = 0.02; d[subscript GMA-raw] = 0.64, and depression, assessed by blinded assessor: Montgomery-Asberg Depression Rating Scale, F(1, 79) = 6.52, p less than 0.01, d = 0.55; clinical global impression, F(1, 79) = 14.77, p less than 0.001, d = 0.85. After treatment discontinuation, depression gains were maintained, but adherence gains were not. Viral load did not differ across condition; however, the CBT-AD condition had significant improvements in CD4 cell counts over time compared with ETAU, gamma[subscript slope] = 2.09, t(76) = 2.20, p = 0.03, d[subscript GMA-raw] = 0.60. Conclusions: In patients managing multiple challenges including HIV, depression, substance dependence, and adherence, CBT-AD is a useful way to integrate treatment of depression with an adherence intervention. Continued adherence counseling is likely needed, however, to maintain or augment adherence gains in this population. (Contains 3 figures, 1 footnote, and 2 tables.)
Descriptors: Acquired Immunodeficiency Syndrome (AIDS), Rating Scales, Substance Abuse, Intervention, Therapy, Depression (Psychology), Cognitive Restructuring, Patients, Drug Abuse, Comorbidity, Correlation, Behavior Modification, Measures (Individuals)
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Publication Type: Journal Articles; Reports - Research
Education Level: N/A
Audience: N/A
Language: English
Sponsor: N/A
Authoring Institution: N/A
Grant or Contract Numbers: N/A