Coping effectiveness training for men living with HIV: results from a randomized clinical trial testing a group-based intervention.
OBJECTIVE
This randomized clinical trial was designed to compare the effects of a theory-based coping effectiveness training (CET) intervention with an active informational control (HIV-Info) condition and a waiting-list control (WLC) condition on psychological distress and positive mood in HIV-seropositive gay men.


METHODS
The authors recruited 149 self-identified gay or bisexual men who were 21 to 60 years of age, reported depressed mood, and had CD4 levels of 200 to 700 cells/mm(3). CET and HIV-Info participants attended 10 90-minute group sessions during the 3-month intervention phase and six maintenance sessions over the remainder of the year. Participants were assessed at baseline and at 3, 6, and 12 months. Data were collected 1992 to 1994, before the introduction of HAART. Analyses were based on the 128 participants who completed the 3-month assessment.


RESULTS
After the 3-month intervention phase, when compared with HIV-Info, CET participants showed significantly greater decreases in perceived stress and burnout, and regression analyses indicated that significant increases in coping self-efficacy mediated the improvements in perceived stress and burnout. Compared with WLC, CET participants also showed significantly greater decreases in anxiety, and regression analyses indicated that significant increases in positive states of mind mediated the improvements in anxiety. Significant treatment group differences for positive morale were maintained at 6 and 12 months. In addition, optimism continued to increase in the CET and HIV-Info treatment groups during the maintenance phase.


CONCLUSIONS
CET can be an effective strategy for managing psychological distress and improving positive psychological states in patients confronting chronic illness.
Chesney
Margaret A
MA
Center for AIDS Prevention Studies, University of California, San Francisco, CA, USA. chesneym@mail.nih.gov
Chambers
Donald B
DB
Taylor
Jonelle M
JM
Johnson
Lisa M
LM
Folkman
Susan
S
D000223:Adaptation, Psychological; D000328:Adult; D001007:Anxiety / Q000453:epidemiology; D001290:Attitude; D001727:Bisexuality / Q000523:psychology; D018791:CD4 Lymphocyte Count; D003863:Depression / Q000453:epidemiology; D037001:Directive Counseling; D015658:HIV Infections / Q000523:psychology*; D006716:Homosexuality / Q000523:psychology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic; D012495:San Francisco; D013315:Stress, Psychological / Q000209:etiology / Q000628:therapy*; D014850:Waiting Lists