Mindfulness-Based Stress Reduction for HIV Treatment Side Effects: A Randomized, Wait-List Controlled Trial

• Published in: Journal of pain and symptom management 2012-02, Vol.43 (2), p.161-171
• Main Authors: Duncan, Larissa G., PhD, Moskowitz, Judith Tedlie, PhD, MPH, Neilands, Torsten B., PhD, Dilworth, Samantha E., MS, Hecht, Frederick M., MD, Johnson, Mallory O., PhD
• Format: Article
• Language: English
• Subjects: Adherence; Anesthesia & Perioperative Care; Anti-Retroviral Agents - therapeutic use; Antiretroviral therapy; Biological and medical sciences; California - epidemiology; Comorbidity; Female; HIV; HIV Infections - drug therapy; HIV Infections - epidemiology; HIV Infections - psychology; Human viral diseases; Humans; Immunodeficiencies; Immunodeficiencies. Immunoglobulinopathies; Immunopathology; Infectious diseases; Male; Medical sciences; Meditation - methods; Meditation - psychology; Middle Aged; Mindfulness-Based Stress Reduction; Pain Medicine; Pharmacology. Drug treatments; Prevalence; Psychological distress; Side effects; Stress, Psychological - epidemiology; Stress, Psychological - prevention & control; Stress, Psychological - psychology; Symptoms; Treatment Outcome; Viral diseases; Viral diseases of the lymphoid tissue and the blood. Aids; Waiting Lists
• ISSN: 0885-3924; 1873-6513
• DOI: 10.1016/j.jpainsymman.2011.04.007

Abstract Context Advances in antiretroviral therapy (ART) for HIV offer life-extending benefit; however, the side effects associated with ART use negatively impact quality of life and medication adherence among people living with HIV. Objectives This study tested the efficacy of Mindfulness-Based Stress Reduction (MBSR) for reducing ART symptoms and bother/distress related to ART side effects. Secondary aims were to test the impact of MBSR on medication adherence and psychological functioning. Methods Seventy-six people living with HIV who were actively taking ART and reported distress from ART-related side effects were randomly assigned to an MBSR program or a wait-list control (WLC) standard care condition. We measured side effects, ART adherence, perceived stress, depression, positive and negative affect, and mindfulness at three time points: baseline, three-month follow-up, and six-month follow-up. Side effects and related distress were assessed separately from other symptoms. Results Compared with a WLC, participants in the MBSR condition experienced a reduction in the frequency of symptoms attributable to ARTs at three months post-intervention (mean difference = 0.33; 95% confidence interval [CI] = 0.01, 0.66; t (132) = 2.04, P = 0.044) and six months post-intervention (mean difference = 0.38; 95% CI = 0.05, 0.71; t (132) = 2.27, P = 0.025). MBSR participants also experienced a reduction in distress associated with those symptoms at three months post-intervention (mean difference = 0.47; 95% CI = 0.003, 0.94; t (132) = 1.99, P = 0.048) compared with the WLC condition. Conclusion MBSR is a promising approach for reducing HIV treatment-related side effects.