Living Well shows promise in helping mental health consumers more effectively manage chronic general medical conditions and experience improved functioning and well-being.

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Given the burden of depression among those with HIV, and the impact of HIV on urban minority communities there is an urgent need to assess innovative treatment interventions that not only treat depression but do so in a way that allows for increased access to mental health care. This single site, uncontrolled, pilot study sought to determine the feasibility and depression outcomes of an 11 session telephone based cognitive behavioral therapy intervention delivered over 14 weeks targeting low income, urban dwelling, HIV infected African-Americans with major depression. The diagnosis of major depression was made using the Mini International Neuropsychiatric Interview. The primary outcome was the HAM-D and the secondary outcome was the Quick Inventory of Depression Symptomatology -Self Report (QIDS-SR). Feasibility and satisfaction were also assessed. Assessments occurred at baseline, midpoint and at study conclusion (14 weeks). Fifteen people were screened for the study. Six HIV infected, low-income, African American individuals (5 Female, 1 Male) were eligible and participated in the study. All patients finished the study. On average, participants completed 9 sessions. The sessions lasted for an average of 48 minutes (SD=11.5). Compared to mean HAM-D score at baseline (HAM-D= 22.8 (SD =3.1), the mean HAM-D score was significantly reduced at study conclusion (HAM-D= 9.8 (SD =7.4);(t (5) =4.6, p=.006);(Cohen d=1.9)). Compared to the mean QIDS-SR score at baseline (QIDS-SR=15.5 (SD =4.2) the mean QIDS score was significantly reduced at study conclusion (QIDS=7.0 (SD =5.4);(t (5) = 3.2, p=.02); (Cohen d=1.3)). The mean satisfaction scores across all participants at post treatment was 5.7 (SD=.3) with of a maximum score of 6. Telephone based CBT can be delivered to low-income, urban dwelling ethnic minority HIV infected people resulting in significant reductions in depression symptoms with high satisfaction. The efficacy of this intervention will be assessed in a planned randomized control trial.

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