Meta-analysis of cognitive-behavioral interventions on HIV-positive persons' mental health and immune functioning.
OBJECTIVE
To evaluate the efficacy of cognitive-behavioral interventions (CBIs) for improving the mental health and immune functioning of people living with HIV (PLWH).


METHODS
Comprehensive searches of electronic databases from 1988 to 2005, hand searches of journals, reference lists of articles, and contacts with researchers. Meta-analytic approaches were used in synthesizing findings.


METHODS
Intervention effects on symptoms of depression, anxiety, and anger, stress, and CD4 cell counts were assessed.


RESULTS
Data from 15 controlled trials were analyzed. Significant intervention effects were observed for improving symptoms of depression (d = 0.33), anxiety (d = 0.30), anger (d = 1.00), and stress (d = 0.43). There is limited evidence suggesting intervention effects on CD4 cell counts (d = 0.08). The aggregated effect size estimates for depression and anxiety were statistically significant in trials that provided stress management skills training and had more than 10 intervention sessions.


CONCLUSIONS
CBIs are efficacious in improving various psychological states of PLWH. Future research should examine the relationship among interventions, psychological states, medication adherence, and immune functions, and identify other relevant factors associated with intervention effects.
Crepaz
Nicole
N
Division of HIV/AIDS Prevention, U.S. Centers for Disease Control and Prevention, Atlanta, GA 30333, USA. ncrepaz@cdc.gov
Passin
Warren F
WF
Herbst
Jeffrey H
JH
Rama
Sima M
SM
Malow
Robert M
RM
Purcell
David W
DW
Wolitski
Richard J
RJ
D000328:Adult; D000786:Anger; D001007:Anxiety; D015928:Cognitive Behavioral Therapy; D003863:Depression; D005260:Female; D006679:HIV Seropositivity / Q000276:immunology / Q000523:psychology*; D006801:Humans; D007107:Immune System / Q000378:metabolism*; D008297:Male; D008603:Mental Health; D008875:Middle Aged; D013315:Stress, Psychological; D016896:Treatment Outcome; D014481:United States