Brandt Charles P, Paulus Daniel J, Lopez-Gamundi Paula, Green Charles, Lemaire Chad, Zvolensky Michael J
Houston OCD Program , Houston , TX , USA.
Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina , Charleston , SC , USA.
AIDS Care. 2019 Dec;31(12):1527-1532. doi: 10.1080/09540121.2019.1597962. Epub 2019 Apr 7.
Research has indicated that mental health disorders, particularly anxiety, predicts poorer antiretroviral medication adherence among persons living with HIV/AIDS (PLWHA). The present study tests a novel six-session Cognitive-Behavioral Therapy-based integrated treatment/management program for PLWHA with concurrent anxiety delivered in community health clinics Houston, Texas. Twenty-Seven PLWHA (= 48.5, SD = 8.9, 44.4% female) were recruited for a proof-of-concept study and randomized to either an active treatment condition, or a waitlist control condition of equal length. Participants were assessed pre-randomization, at the mid-treatment time point (after three sessions for the active participants and three weeks for the control participants) and post-treatment (six sessions for active participants, six weeks for control participants). Data were examined used Bayesian multilevel models. Results indicated a reliable (99.87% posterior probability of a moderating effect) interaction between active and control groups for depressive symptoms and reliable (99.65% probability) interaction for anxiety symptoms. Results indicated an unreliable interaction for combined antiretroviral therapy adherence. These findings are discussed in terms of the feasibility and potential utility of administering an anxiety-reduction therapy program designed for PLWHA with HIV medication adherence difficulties.
研究表明，心理健康障碍，尤其是焦虑症，预示着艾滋病毒/艾滋病感染者（PLWHA）对抗逆转录病毒药物的依从性较差。本研究在德克萨斯州休斯顿的社区健康诊所，对一种新颖的、基于认知行为疗法的六节综合治疗/管理项目进行了测试，该项目针对同时患有焦虑症的PLWHA。招募了27名PLWHA（平均年龄=48.5岁，标准差=8.9，44.4%为女性）进行概念验证研究，并随机分为积极治疗组或同等时长的等待名单对照组。在随机分组前、治疗中期时间点（积极参与者进行三节治疗后，对照参与者为三周后）和治疗后（积极参与者进行六节治疗，对照参与者为六周后）对参与者进行评估。使用贝叶斯多层次模型对数据进行检验。结果表明，积极治疗组和对照组在抑郁症状方面存在可靠的交互作用（调节效应的后验概率为99.87%），在焦虑症状方面存在可靠的交互作用（概率为99.65%）。结果表明，在联合抗逆转录病毒治疗依从性方面存在不可靠的交互作用。针对为有艾滋病毒药物依从性困难的PLWHA设计的减轻焦虑治疗项目的可行性和潜在效用，对这些发现进行了讨论。
