Study results show that those who completed CBT-AD sessions were more than 2.5 times more likely to achieve undetectable viral loads than those who underwent the usual care.
Nurses training to deliver adapted cognitive behavior therapy (CBT) at public HIV clinics can help individuals with depression and uncontrolled HIV adhere to their medication regiment, the results of a study show.
“We know that treating HIV-positive people who are clinically depressed with antidepressants alone does not affect their viral loads. Their depression may improve, but their adherence does not,” Steven Safren, professor of psychology and director of the center for HIV/AIDS research and mental health at the University of Miami, said in a statement.
“We showed it is possible to train nurses to deliver cognitive-behavioral therapy for adherence and depression (CBT-AD), an intervention that successfully addresses both clinical depression and uncontrolled HIV,” he said.
Investigators found that individuals who completed CBT-AD sessions were more than 2.5 times more likely to achieve undetectable viral loads than those who underwent the usual care.
The study included 161 individuals with AIDS/HIV and clinical depression from 4 public health clinics in the township of Khayelitsha, South Africa.
They found that South Africa only has 0.28 psychiatrists and 0.32 psychologists per 100,000 individuals, though physicians can prescribe antidepressants.
All individuals in the study received the usual care for clinical depression and AIDS/HIV. Each individual did not achieve viral suppression after receiving the first month of their antiretroviral medication.
Half the individuals were randomly assigned to attend 8 CBT-AD sessions where trained nurses used strategies for treating depression with counseling that included depression, life skills, mood monitoring, problem solving, and relaxation.
To track their adherence, individuals received an electronic pill box that, when opened, would transmit a real-time signal to a web server.
The next step will be for investigators to evaluate how to suitably implement the CBT-AD approach in South Africa, or even South Florida, Safren said.
Researchers develop model for treating HIV/AIDS, depression. EurekAlert. News release. December 1, 2021. Accessed December 2, 2021. https://www.eurekalert.org/news-releases/936605