HIV Anxiety Reduction/Management Program (HAMRT): pilot randomized controlled trial

• Published in: AIDS care 2019-12, Vol.31 (12), p.1527-1532
• Main Authors: Brandt, Charles P., Paulus, Daniel J., Lopez-Gamundi, Paula, Green, Charles, Lemaire, Chad, Zvolensky, Michael J.
• Format: Article
• Language: English
• Subjects: Acquired immune deficiency syndrome; Active control; Adherence; AIDS; AIDS/HIV; Antiretroviral agents; Antiretroviral therapy; Anxiety; Bayesian analysis; Clinical trials; Cognitive ability; Cognitive Behavior Therapy; Cognitive behavioral therapy; Community health; Community health services; Conditional probability; depression; Drugs; Evidence-based medicine; Feasibility; HIV; HIV/AIDS; Human immunodeficiency virus; Mathematical models; medication adherence; Mental depression; Mental disorders; Mental health; Patient compliance; Prescription drugs; Randomization; Reduction; Signs and symptoms; Symptoms; Therapy
• ISSN: 0954-0121; 1360-0451
• DOI: 10.1080/09540121.2019.1597962

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 (M age  = 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.