title: Cognitive-behavioural stress management with HIV-positive homosexual men: mechanisms of sustained reductions in depressive symptoms.
abstract: BACKGROUND
  We examined the sustained efficacy of a group-based cognitive-behavioural stress management (CBSM) intervention in comparison to a modified wait-list control condition on measures of mood, coping and social support in mildly symptomatic HIV-positive homosexual and bisexual men. Participants were recruited largely during the era prior to highly active antiretroviral therapy (HAART; 1992-1997).
  
  
  METHODS
  Men were randomized to either a 10-week, group-based CBSM intervention (n = 83) or a psychoeducational seminar group (n = 46). All participants completed a battery of psychosocial questionnaires administered by a research assistant at baseline, immediately following the 10-week CBSM intervention period, and at a 6-month follow-up.
  
  
  RESULTS
  Men in the CBSM group maintained previously observed effects on depressive symptoms and perceived social support. These sustained effects of CBSM on depressive symptoms were mediated by 10-week increases in cognitive coping (i.e. positive reframing).
  
  
  CONCLUSIONS
  CBSM appears to be a potentially efficacious treatment that reduces and maintains lower levels of depressive symptoms and enhances social support in HIV-positive homosexual and bisexual men. In particular, changes in positive reframing during the 10-week intervention period remain a crucial factor contributing to sustained reductions in depressive symptoms.
authors.affiliation: Department of Psychology, PO Box 249229, University of Miami, Coral Gables, FL 33146, USA.
authors.forename: Adam W
authors.initials: AW
authors.lastname: Carrico
authors.forename: Michael H
authors.initials: MH
authors.lastname: Antoni
authors.forename: Kathryn E
authors.initials: KE
authors.lastname: Weaver
authors.forename: Suzanne C
authors.initials: SC
authors.lastname: Lechner
authors.forename: Neil
authors.initials: N
authors.lastname: Schneiderman
mesh_terms: D000328:Adult; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D003863:Depression / Q000209:etiology / Q000523:psychology / Q000628:therapy*; D005500:Follow-Up Studies; D006679:HIV Seropositivity / Q000150:complications* / Q000523:psychology; D018451:Homosexuality, Male; D006801:Humans; D008297:Male; D013315:Stress, Psychological / Q000150:complications / Q000523:psychology / Q000628:therapy*; D016896:Treatment Outcome