Online Self-Help Tool Combats Depression Caused by HIV

A study protocol was created for a randomized clinical trial that will test the

efficacy

of an online self-help program for HIV positive patients with depressive symptoms.

The newly developed program is based on a self-help cognitive behavioral therapy with a goal to help combat the fear of others learning about an individual’s HIV positive status.

People living with HIV often experience depressive symptoms, which results in a higher risk of medication non-adherence.

To treat and manage depression, individual and group therapies are available and many of them have cognitive behavioral components. Although these options are effective, there are still some disadvantages that patients with HIV are faced with.

For patients to receive treatment, a face-to-face meeting during office hours is needed and the costs are high. Furthermore, the HIV stigma acts as a significant barrier to service delivery and utilization. Online self-help programs could provide a way to overcome these challenges.

The online self-help program contains 8 lessons, with completion taking 1 to 2 hours a week for 6 to 10 weeks. Prior studies have shown the effectiveness of these programs in patients suffering from a chronic illness.

The online program has been expanded in the proposed study to include an activation component where participants will be are stimulated to perform small activities like waking up on time. It also includes minimal and motivational coaching and it will be available in Dutch and English in order to reach more patients in the future.

The study will examine the efficacy of the program with a randomized controlled trial that will compare the intervention group against a waiting list control group. At least 200 participants with mild-to-moderate depressive symptoms will be given a pretest and 3 post tests.

The 4 main components of the program consists of activation, relaxation, changing maladaptive cognitions, and goal attainment that will last 6 to 10 weeks. During the program, individuals in the depressive symptoms group will have a coach that provides them with motivational support by telephone once a week.

Participants in the control group will be provided with weekly minimal support from a coach for 8 weeks. After the second post-test is completed, individuals will have access to the self-help program.

During the intervention and waiting period, depressive symptoms, and possible mediators that includes activation, cognitive coping, self-efficacy, and goal adjustment will be assessed 3 times by a self-report. Assessment will also take place at the pretest and first post-test.

If the intervention proves to be effective, the program will be implemented in cooperation with the Dutch patient organization and HIV treatment centers.

This implementation could reach many more HIV patients and help improve their psychological care.