Systematic Review of Cognitive Behavior Therapy to Improve Mental Health of Women Living with HIV

Abstract

Psychological distress is highly prevalent in people living with HIV. Cognitive behavior therapy (CBT) has been associated with improved mental health outcomes in HIV-infected men who have sex with men (MSM); however, little is known of its effect in women living with HIV/AIDS (WLHA). We review current literature on CBT and its effects on depression, anxiety, stress and mental health quality of life (QOL) in WLHA. We undertook a systematic review of the literature indexed in PubMed, Medline, Psychiatry Online and ScienceDirect. Of the 273 relevant studies discovered, 158 contained duplicate data, and 105 studies did not meet the inclusion and exclusion criteria, yielding 10 studies for analysis. Data were independently extracted by each researcher, with differences resolved through discussion and consensus. For WLHA, CBT substantially improved QOL, symptoms of depression and stress, but appeared to have less impact on anxiety. Three of the six studies measuring depression outcomes showed statistically significant decreases in depression. Three of three studies measuring mental health QOL, and three of three studies measuring stress also demonstrated statistically significant improvement. Two of two studies measuring anxiety did not show statistically significant change. CBT is a promising therapy for WLHA. CBT may reduce psychological distress, improving symptoms of depression, stress and QOL. There is a need for additional, better standardized studies that examine CBT for WLHA.

Feasibility and Acceptability of a Program to Promote Positive Affect, Well-Being and Gender Empowerment in Black Women Living with HIV

“…Self-silencing among WLWH has been associated with higher likelihood of depression [ 38 ], a lower likelihood of engaging in safe-sex behavior [ 29 ], and a lower likelihood of achieving ≥ 95% antiretroviral therapy (ART) adherence, especially among women who are racial/ethnic minorities or who have a history of abuse [ 30 ]. These multiple risk factors exist within the context of gender and racial inequities, and many researchers have called for interventions that specifically increase gender empowerment among WLWH to improve symptoms of depression, self-care and medication adherence [ 31 ].…”

Evaluation of a Newly Developed Transdiagnostic Cognitive Behavioral Therapy Group to Promote Healthy Aging Among Older People with HIV: Study Protocol for a Pilot Randomized Controlled Trial

“…There is strong evidence that cognitive behavioral therapy (CBT) effectively reduces psychological distress and improves health behaviors (eg, ART adherence) and outcomes (eg, viral load) in PWH. [40][41][42][43][44][45] CBT skills include cognitive restructuring (ie, changing maladaptive thinking patterns), activity scheduling, and problem-solving. [46][47][48] Contemporary CBT skills also include mindfulness (ie, purposively and non-judgmentally attending to the present moment), 49 metacognition (ie, awareness of one's thought process), 50 self-compassion (ie, extending compassion to one's self), 51 personal values, and acceptance (ie, active embracing subjective experiences).…”

Effects of cognitive behavioral therapy on improving depressive symptoms and increasing adherence to antiretroviral medication in people with HIV

“…In recent years, CBT has been widely used by many researchers in the management of mental health of PLWH. CBT has been shown to be effective in improving adherence, depressive symptoms, stress, and quality of life in PLWH IDUs (injecting drug users), MSM (men who have sex with men), etc., ( 11 – 14 ) and more effective in reducing depressive symptoms and increasing ART medication adherence than other psychological intervention models ( 15 ). Therefore, this study examines the effect of CBT on the remission of depressive symptoms and adherence to ART medication in PLWH.…”