title: Meta-analysis of cognitive-behavioral interventions on HIV-positive persons' mental health and immune functioning.
abstract: 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.
authors.affiliation: Division of HIV/AIDS Prevention, U.S. Centers for Disease Control and Prevention, Atlanta, GA 30333, USA. ncrepaz@cdc.gov
authors.forename: Nicole
authors.initials: N
authors.lastname: Crepaz
authors.forename: Warren F
authors.initials: WF
authors.lastname: Passin
authors.forename: Jeffrey H
authors.initials: JH
authors.lastname: Herbst
authors.forename: Sima M
authors.initials: SM
authors.lastname: Rama
authors.forename: Robert M
authors.initials: RM
authors.lastname: Malow
authors.forename: David W
authors.initials: DW
authors.lastname: Purcell
authors.forename: Richard J
authors.initials: RJ
authors.lastname: Wolitski
mesh_terms: 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