The efficacy of Structural Ecosystems Therapy for HIV medication adherence with African American women.

Feaster, Daniel J.; Brincks, Ahnalee M.; Mitrani, Victoria B.; Prado, Guillermo; Schwartz, Seth J.; Szapocznik, José

doi:10.1037/a0017954

Cited by 24 publications

(23 citation statements)

References 53 publications

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“…Of the 29 studies in the meta-analysis, only one study formally tested change in depressive symptoms or psychological distress as a predictor of change in ART adherence; the study found no significant relationship between the rate of change in psychological distress and change in adherence (40). Studies of collaborative care for depression (23) and cognitive behavioral stress management (22, 41) did show improvements in depression outcomes but not ART adherence.…”

Section: Resultsmentioning

confidence: 99%

Depression Treatment Enhances Adherence to Antiretroviral Therapy: a Meta-Analysis

2013

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BACKGROUND Depression is a risk factor for nonadherence to HIV/AIDS treatment. PURPOSE A meta-analysis was conducted to examine whether treatment of depression and psychological distress improves antiretroviral therapy adherence. METHODS PubMed and PsycINFO databases were systematically searched for relevant articles. Studies that reported an association between depression treatment (or an intervention with a component addressing mental health) and antiretroviral adherence were included. RESULTS Across 29 studies of 12,243 persons living with HIV/AIDS, treatment of depression and psychological distress improved antiretroviral adherence (p < .001). The odds of a person adhering were 83% better if he/she was treated for depression. Greater improvements in adherence were found for samples with lower CD4 counts or more severe depression, for interventions specifically targeting depression (versus addressing mental health as a secondary objective), longer treatments, and observational studies. CONCLUSIONS These findings support the need for detection and treatment of depression among persons living with HIV/AIDS.

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Section: Resultsmentioning

confidence: 99%

Depression Treatment Enhances Adherence to Antiretroviral Therapy: a Meta-Analysis

2013

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“…Familial conflict refers to disagreements between family members, often immediate family who are same household residents, which can be either acute or chronic [29,30,31]. Literature on familial conflict suggests that HIV diagnosis represents a chronic stressor, which may reinforce substance use and/or mental illness among PLHIV [27,28,30,32].…”

Section: Introductionmentioning

confidence: 99%

Gender Differences in Psychosocial Factors Associated with HIV Viral Suppression Among African–American Injection Drug Users

Robinson

Knowlton

2015

AIDS Behav

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Objective Research suggests gender differences exist in achieving undetectable viral load (UVL) among persons living with HIV (PLHIV), and that social and behavioral health factors may play a role. Method Data were from African-American PLHIV in the BEACON study. Participants completed self-report surveys and gave biomarker data. Poisson regression with robust standard errors was implemented. Results Men with moderate religious activity had 1.3 times the likelihood of UVL as men with low religious activity (p<.10; N=199). Men with 1-2 mental illness diagnoses had 1.3 times the likelihood of UVL as men with none (p<.05). Women using 1-2 substances had 28% lower likelihood of UVL than non-using women (N=122; p<.10). Finally, women with frequent doctor-patient communication had 35% higher likelihood of UVL as women with less doctor-patient communication (p<.05). Conclusions Results suggest that social support, substance use, and mental illness function differently among men and women. Healthcare professionals should employ gender-specific interventions to address and improve HIV health outcomes.

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“…Structural Ecosystems Therapy (SET; Mitrani et al, 2009) is a family based intervention for poor inner-city HIV+ women targeting psychosocial factors (e.g., reduced family stress and increased family support) associated with progressions in HIV symptoms. In a previous randomized clinical trial, SET showed efficacy in reducing psychological distress and family-related irritation (Szapocznik et al, 2004), lowering rates of relapse (Feaster, Burns, et al, 2010), and increasing medication adherence (Feaster, Brincks, et al, 2010). The current study extends previous findings by testing the efficacy of SET for improving HIV medication adherence and reducing relapse as compared to a Health Group (HG) intervention for women in recovery.…”

Section: Introductionmentioning

confidence: 99%

A randomized controlled trial of Structural Ecosystems Therapy for HIV medication adherence and substance abuse relapse prevention

Feaster

Mitrani

Burns

et al. 2010

Drug and Alcohol Dependence

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BACKGROUND-Substance abuse in women with HIV/AIDS overshadows other priorities, including health care. Substance abuse may cause women to avoid health care systems and not adhere to their medication regimen.METHODS-A randomized controlled trial tested the efficacy of Structural Ecosystems Therapy (SET) relative to a psychoeducational health group (HG) in 126 HIV+ women in recovery. SET, a 4-month intervention, focused on building family support for relapse prevention and HIV medication adherence. Over 12-month follow-up, women were assessed for drug use and medication adherence every 2-months; CD4 T-cell count and HIV viral load were assessed every 4-months.RESULTS-Levels of drug use did not differ by condition. There was a significant difference in curvature of the rates of change in drug use with SET increasing and then decreasing and HG decreasing and then increasing. Women in SET were more likely to increase substance abuse services in response to relapse and separate from drug using household members than were women in HG. These two changes explained the decline in drug use observed within SET between 6 and 12 months. SET showed declines in medication adherence but increases in CD4 T-cell count relative to HG. The Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. increase in CD4 T-cell count in SET was related to increasing proportions of women in SET taking antiretroviral medications. NIH Public Access CONCLUSION-The results of the trial were mixed. Women in SET did not show better drug use or medication adherence outcomes, but did show improvement in CD4 T-cell count and theoretical mechanisms of action on drug relapse.

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The efficacy of Structural Ecosystems Therapy for HIV medication adherence with African American women.

Cited by 24 publications

References 53 publications

Depression Treatment Enhances Adherence to Antiretroviral Therapy: a Meta-Analysis

Depression Treatment Enhances Adherence to Antiretroviral Therapy: a Meta-Analysis

Gender Differences in Psychosocial Factors Associated with HIV Viral Suppression Among African–American Injection Drug Users

A randomized controlled trial of Structural Ecosystems Therapy for HIV medication adherence and substance abuse relapse prevention

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