Objective To evaluate the immediate and longer-term effectiveness of Mindfulness-based Stress Reduction (MBSR) among treatment adherents on CD4+ T Lymphocyte Count (CD4 count) and medical and psychological symptoms among HIV+ patients in Tehran, Iran. Methods Using a randomized controlled trial design, data were analyzed from 173 HIV+ patients (CD4 Count > 250) not yet receiving antiretroviral therapy who participated in either an 8-week MBSR (n=87) or a brief education and support condition (ESC) (n=86) at the Imam Khomeini Hospital. Assessments included CD4 count, Symptom Checklist-90-Revised (SCL-90R), and Medical Symptom Checklist (MSCL) at baseline, immediate post-test, and 3, 6, 9 and 12-month follow-up periods. Results The treatment adherent sample had a mean age of 35.1(SD = 6.5) years and 69% were male. Linear mixed model estimates indicated mean CD4 count increased from baseline up to 9 months post-treatment, then returned to baseline level at 12 months. Improvements in mean SCL-90R (up to 6 months) and MSCL (up to 12 months) scores were observed for the MBSR condition while ESC scores remained the same over time; however, only MSCL improvements significantly differed between groups and these changes lasted up to the final assessment. Conclusions Findings suggest that among treatment adherent Iranian HIV+ patients not yet receiving antiretroviral drug treatment, MBSR appears to have the strongest potential to improve self-reported physical symptomatology. Trial Registration Iranian Registry of Clinical Trials IRCT201106084076N2.

HIV prevalence among street children is much higher than general population (<0.1%), and in fact ,the rate of positivity comes close to that among female sex workers in Iran. These findings must be an alarm for HIV policymakers to consider immediate and special interventions for this at-risk group.