Randomized clinical trial of cognitive behavioral stress management on human immunodeficiency virus viral load in gay men treated with highly active antiretroviral therapy
Randomized clinical trial of cognitive behavioral stress management on human immunodeficiency virus viral load in gay men treated with highly active antiretroviral therapy
复制标题
DOI：
10.1097/01.psy.0000195749.60049.63
复制
发表时间：
2006-01-01
影响因子：
3.3
通讯作者：
Schneiderman, N
中科院分区：
文献类型：
--
作者：
Antoni, MH;Carrico, AW;Schneiderman, N
目的：接受高效抗逆转录病毒疗法（HAART）治疗的人类免疫缺陷病毒（HIV）阳性个体可能会经历心理负担和负面情绪状态，这可能会削弱他们从医疗中获得最大益处的能力。我们测试了临床药剂师进行的认知行为压力管理（CBSM）干预结合抗逆转录病毒药物依从性培训（MAT）是否比单独的MAT对HIV病毒载量影响更大。
方法：男男性行为的HIV阳性者被随机分配到为期10周的CBSM + MAT干预组（n = 76）或仅MAT组（n = 54）。在基线、10周干预期结束后立即、随机分组后9个月以及随机分组后15个月收集数据。
结果：我们发现随机分组的130名男性的HIV病毒载量没有差异。然而，在基线时病毒载量可检测的101名男性中，在控制药物依从性后，随机分配到CBSM + MAT组（n = 61）的男性在15个月期间HIV病毒载量降低了0.56 log(10)单位。仅MAT组（n = 40）的男性没有变化。干预期间抑郁情绪的降低解释了CBSM + MAT在15个月内对HIV病毒载量降低的作用。
结论：一种限时的CBSM + MAT干预，通过调节抑郁情绪，可能会增强HAART对可检测血浆水平的HIV阳性男性抑制HIV病毒载量的效果。
关键词：抑郁；HIV/艾滋病；HIV病毒载量；干预
Objective: Human Immunodeficiency Virus (HIV)-positive individuals treated with highly active antiretroviral therapy (HAART) may experience psychological burdens and negative mood states, which could impair their ability to derive maximum benefits from their medical treatment. We tested whether a cognitive behavioral stress management (CBSM) intervention in combination with antiretroviral medication adherence training (MAT) from a clinical pharmacist influences HIV viral load more than MAT alone. Methods: HIV-positive men who have sex with men were randomized to either a 10-week CBSM + MAT intervention (n = 76) or a MAT-Only condition (n = 54). Data were collected at baseline immediately following the 10-week intervention period, at 9 months postrandomization, and at 15 months postrandomization. Results: We found no differences in HIV viral load among the 130 men randomized. However, in the 10 1 men with detectable viral load at baseline, those randomized to CBSM + MAT (n 6 1) displayed reductions of 0.56 log(10) units in HIV viral load over a 15-month period after controlling for medication adherence. Men in the MAT-Only condition (n = 40) showed no change. Decreases in depressed mood during the intervention period explained the effect of CBSM + MAT on HIV viral load reduction over the 15 months. Conclusions: A time-limited CBSM + MAT intervention that modulates depressed mood may enhance the effects of HAART on suppression of HIV viral load in HIV+ men with detectable plasma levels. Key words: depression, HIV/AIDS, HIV viral load, intervention.