Evaluation of the Effect of Cognitive-behavioral Therapy on Adherence to Treatment and General Health in HIV Positive Patients.

Document Type: Research Paper

Authors

1 Assistant Professor of Psychology, Department of Psychology, Islamic Azad University, Sari Branch, Sari, Iran

2 PhD Student of Psychology, Islamic Azad University, Sari, Sari, Iran

Abstract

The aim of this study was to evaluate the effect of cognitive-behavioral therapy on adherence to treatment and general health of HIV positive patients. In a quasi-experimental design, 30 HIV positive patients referred to Imam Khomeini Hospital for treatment were randomly selected, and then, they were randomly assigned into two groups of the experiment (n = 15) and control (n = 15). Pre-test was performed for both groups before intervention. The experimental group received 12 sessions of cognitive-behavioral therapy, 1 session per week, but the control group did not receive any intervention. Then, both groups completed post-test and finally, both groups completed the research questionnaires after 3 months (3 months follow-up). Data were collected using the General Health Questionnaire (GHQ 28) and Modanlou Adherence to Treatment Questionnaire. The collected data were analyzed by covariance analysis. The results showed a significant difference between experimental and control groups in terms of adherence to treatment and general health in the pre-test, post-test and follow-up stages (P <0.05). The results of this study suggest that cognitive-behavioral therapy can improve adherence to treatment and general health in HIV positive patients.

Keywords


  1. Posht Chaman, Z, Jadid Milani, M, Atashzadeh Shourideh, F, and Akbarzadeh Baghban, A (2014). Evaluation of adherence to treatment of patients after coronary artery bypass graft surgery in Tehran hospitals in 2014. Journal of Sabzevar University of Medical Sciences. Volume 22 / Issue 4 / October & November 2015.
  2. Tarkashvand, F. Asadpour, M, Sheikh Fatollahi, M, Sheikhi, E., Salehi, MH. (2015). Frequency of high-risk behaviors in HIV-infected people referring to the Kerman and Rafsanjan Behavioral Therapy Centers in 2012, Third University of Tehran. Volume 14, October 2015, 587-598.
  3. Taghavi, SMR (2001), examining the reliability and validity of General Health Questionnaire (GHQ), Journal of Psychology, 20, 98-381.
  4. Razaghian, A (2015). The effect of cognitive-behavioral therapy on mental health and social adjustment in addicts. Master thesis, Sari Azad University.
  5. Selghi, Z., Hashemi, K, and Saeedipour, B (2007). The effect of group cognitive therapy on reducing depression in HIV-positive male patients. Psychological Studies of Al-Zahra School of Education and Psychology, Volume 3, Issue 4.
  6. Shams, M., Karimzadeh Shirazi, K., Fararuei., M, and Shariatinia, S (2016). Developing AIDS Literacy Assessment Tool for Iranian Society. Journal of Ilam University of Medical Science, Volume 24, Issue 5.
  7. Shushtari, A., Rezaei, AM. Taheri, E (2016). The Effectiveness of the cognitive-behavioral therapy emotional adjustment, meta-cognitive beliefs, and rumination of divorced women, Journal of Mental Health Principles. 95, 8–321.
  8. Shokr Beighi, A, Yasminejad, P (2012). Comparing the parenting styles, self-esteem, and general health of male young offender and normal people in Kermanshah, Journal of Family Counseling and Psychotherapy, Volume, 2, Issue 2
  9. Samadzadeh, N, Poursharifi, H, And Babapour, J (2015). The Effectiveness of Cognitive Behavioral Therapy on Self-Care and Symptoms of Depression and Anxiety in Women with Type 2 Diabetes: A Case Study. Feyz Journal of Research, Volume 19, Issue 3, 255-264
  10. Gholamali, B, Karimi, A, Roshanaei, Gh., and Rezapour Shahkalaei, F (2015). Adherence to drug therapy and its related factors in type 2 diabetic patients, Volume 4, Winter 2015, 3-12.
  11. White, Creek, A. (2010). Cognitive-behavioral therapy for chronic medical patients: A practical guide for evaluation and treatment. (Translators: Moloudi, R., Fatahi, K). Tehran: Arjmand Publications, (Published in Original Language, 2001).
  12. Antoni, M. H., Lechner, S., Kazi, A., Wimberly, S., Sifre, T., Urcuyo, K., & Carver, C. S. (2006). How stress management improves quality of life after treatment for breast cancer. Journal of Consulting and Clinical Psychology, 74, 1143–1152.
  13. Aranda, a and naranjo, b. (2004). Quality of life in HIV positive patiente. Journal association nurses aids care, 15: 265-273.
  14. Blashill, A. J., Safren, S. A., Wilhelm, S., Jampel, J., Taylor, S. W., O'Cleirigh, C., & Mayer, K. H. (2017). Cognitive behavioral therapy for body image and self-care (CBT-BISC) in sexual minority men living with HIV: A randomized controlled trial. Health Psychology, 36(10), 937.
  15. Brandt, C. P., Paulus, D. J., Garza, M., Lemaire, C., Norton, P. J., & Zvolensky, M. J. (2017). A Novel Integrated Cognitive-Behavioral Therapy for Anxiety and Medication Adherence Among Persons Living With HIV/AIDS. Cognitive and Behavioral Practice.
  16. Boyer, B. A., & Paharia, M. I. (Eds.). (2008). Comprehensive. handbook of clinical health psychology. John Wiley & Sons.
  17. Collins, P. Y., Holman, A. R., Freeman, M. C., & Patel, V. (2006). What is the relevance of mental health to HIV/AIDS care and treatment programs in developing countries? A systematic review. AIDS (London, England), 20(12), 1571.
  18. Carrico, A. W., Antoni, M. H., Pereira, D. B., Fletcher, M. A., Klimas, N., Lechner, S. C., & Schneiderman, N. (2005). Cognitive behavioral stress management effects on mood, social support, and a marker of antiviral immunity are maintained up to 1 year in HIV-infected gay men. International Journal of Behavioral Medicine, 12(4), 218-226.
  19. Carr RL, Gramling LF. (2012). Stigma: a health barrier for women with HIV/AIDS. Thailand: Information was collected from electronic databases and websites using the search terms 'HIV stigma healthcare':11-31.
  20. Dale, S. K., & Safren, S. A. (2017). Striving Towards Empowerment and Medication Adherence (STEP-AD): A Tailored Cognitive Behavioral Treatment Approach for Black Women Living With HIV. Cognitive and Behavioral Practice.
  21. Esposito-Smythers, C., Brown, L. K., Wolff, J., Xu, J., Thornton, S., & Tidey, J. (2014). Substance abuse treatment for HIV infected young people: An open pilot trial. Journal of substance abuse treatment, 46(2), 244-250.
  22. Fauci, A. S., & Folkers, G. K. (2012). Toward an AIDS-free generation. Jama, 308(4), 343-344.
  23. Gulliksson,M., Burell,G., Vessby, B., Lundin, L., Toss, H.,& Svärdsudd, K. (2011). Randomized controlled trial of cognitive behavioral therapy vs standard treatment to prevent recurrent cardiovascular eventsin patients with coronary heart disease: Secondary Prevention in Uppsala Primary Health Care project (SUPRIM). Archives of Internal Medicine, 171(2), 134–140.
  24. Huggins, J. L., Bonn-Miller, M. O., Oser, M. L., Sorrell, J. T., & Trafton, J. A. (2012). Pain anxiety, acceptance, and outcomes among individuals with HIV and chronic pain: A preliminary investigation. Behaviour Research and Therapy, 50(1), 72–78.
  25. HIV/AIDS JUNPo. Gap report 2013: UNAIDS; 2014. Available at:http://www.unaids.org/en/media/unaids/contentassets/documents/unaidspubli cation/2014/UNAIDS_Gap_report_en.pdf
  26. Hart, T. A., Tulloch, T. G., & O’Cleirigh, C. (2014). Integrated cognitive behavioral therapy for social anxiety and HIV prevention for gay and bisexual men. Cognitive and Behavioral Practice, 21(2), 149-160.
  27. Jayasvasti, I., Hiransuthikul, N., Pityaratstian, N., Lohsoonthorn, V., Kanchanatawan, B., & Triruangworawat, B. (2011). The effect of cognitive behavioral therapy and changes of depressive symptoms among Thai adult HIV-infected patients. World Journal of AIDS, 1(02), 15.
  28. Jin J, sklar GE, Min Sen Oh V, Li SC.Factors affecting therapeutic compliance: A review from the patients perspective. Therapeutics perspective. Ther Clin Risk Manag. 2008; 4(1): 269-86.
  29. Kennard, B. D., Brown, L. T., Hawkins, L., Risi, A., Radcliffe, J., Emslie, G.J & Bethel, J. (2014). Development and implementation of health and wellness CBT for individuals with depression and HIV. Cognitive and behavioral practice, 21(2), 237-246.
  30. Kalichman, S. C., & Grebler, T. (2010). Stress and poverty predictors of treatment adherence among people with low-literacy living with HIV/AIDS. Psychosomatic medicine, 72(8), 810.
  31. Mermin, J., & Fenton, K. A. (2012). The future of HIV prevention in the United States. JAMA: Journal of the American Medical Association, 308(4), 347–348.
  32. Moore, J. (2004). The Puzzling Origins of AIDS: Although no one explanation has been universally accepted, four rival theories provide some important lesson. American Scientist, 92(6), 540-547.
  33. Moore, B. A., Rosen, M. I., Wang, Y., Shen, J., Ablondi, K., Sullivan, A. & Liu, H. (2015). A remotely-delivered CBT and contingency management therapy for substance using people with HIV. AIDS and Behavior, 19(2), 156-162.
  34. Nathan, P. E., & Gorman, J. M. (2015). A guide to treatments that work (4th ed.). New York, NY: Oxford University Press.
  35. O’Cleirigh, C. M., Stein, M., & Safren, S. A. (2015). Depression CBT treatment gains among HIV-infected persons with a history of injection drug use varies as a function of baseline substance use. Psychology, health & medicine, 20(7), 870-877.
  36. Safren, S. A., Bedoya, C. A., O'Cleirigh, C., Biello, K. B., Pinkston, M. M., Stein, M. D., ... & Herman, D. S. (2016). Cognitive behavioural therapy for adherence and depression in patients with HIV: a three-arm randomised controlled trial. The Lancet HIV, 3(11), e529-e538.
  37. Spies, G., Asmal, L., & Seedat, S. (2013). Cognitive-behavioural interventions for mood and anxiety disorders in HIV: a systematic review. Journal of affective disorders, 150(2), 171-180.‏
  38. Sabet, A. H., Khalatbari, J., Ghorbani, M. A., Haghighi, M., & Ahmadpanah, M. (2013). Group training of stress management vs. group cognitive-behavioral therapy in reducing depression, anxiety and perceived stress among HIV-positive men. Iranian journal of psychiatry and behavioral sciences, 7(1), 4.
  39. Soroudi, N., Perez, G. K., Gonzalez, J. S., Greer, J. A., Pollack, M. H., Otto, M. W., & Safren, S. A. (2008). CBT for medication adherence and depression (CBT-AD) in HIV-infected patients receiving methadone maintenance therapy. Cognitive and Behavioral Practice, 15(1), 93-106.
  40. Trafton, J. A., Sorrell, J. T., Holodniy, M., Pierson, H., Link, P., Combs, A., & Israelski, D. (2012). Outcomes associated with a cognitive-behavioral chronic pain management program implemented in three public HIV primary care clinics. The journal of behavioral health services & research, 39(2), 158-173.
  41. UNAIDS, G. A. (2016). update 2016. Joint United Nations Programme on HIV/AIDS (UNAIDS).
  42. Unge C, Sodergard B, Marrone G, et al. Long-term adherence to antiretroviral treatment and program drop-out in a high-risk urban setting in sub-Saharan Africa: a prospective cohort study. PLoS ONE. 2010;5(10):e13613.
  43. Waldrop-Valverde D, Osborn CY, Rodriguez A, Rothman RL, Kumar M, Jones DL. Numeracy skills explain racial differences in HIV medication management. AIDS Behav. 2009 Aug 8;
  44. World Health Organization (WHO). Policy Brief: Consolidated Guidelines on the Use of Antiretroviral Drugs for Treating and Preventing HIV Infection: What’s New. WHO website. http://apps.who.int/iris/bitstream/10665/198064/1/9789241509893_eng.pdf?ua=1. 2015. Accessed December 31, 2015.
  45. Young, S., Wheeler, A. C., McCoy, S. I., & Weiser, S. D. (2014). A review of the role of food insecurity in adherence to care and treatment among adult and pediatric populations living with HIV and AIDS. AIDS and Behavior, 18(5), 505-515