Telephone Intervention /Depressed Older Adults /HIV/AIDS

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DESCRIPTION (provided by applicant): Through June 2000, more than 81,000 persons living with AIDS in the United States were 50 years of age or older at the time of theft diagnosis. However, because AIDS mental health research has focused primarily on young individuals living with HIV disease, many geropractitioners have a poor conceptualization of the mental health needs of older adults living with HIV/AIDS. Across a series of preliminary studies supported by NIA, our study team has characterized levels of life-stressor burden, coping difficulties, and psychological distress among late middle-aged and older adults living with HIV/AIDS. Our formative research portends that many HIV-infected older adults experience elevated levels of depressive symptomatology and suicidal ideation, high levels of life-stressor burden, and heightened perceptions of isolation. Recently, the P.I. and colleagues demonstrated that a coping improvement group intervention designed specifically for HIV-infected older adults can improve the adjustment efforts and life quality of this group. Using a lagged-treatment control-group design, the proposed Phase I clinical trial will evaluate the short-term and longer-term effects of a telephone-delivered, coping improvement group intervention on the adjustment efforts of 80 HIV-infected persons 50-plus years of age who meet diagnostic criteria for depression. The intervention is based on Lazarus and Folkman's (1984) Transactional Model of Stress and Coping and uses cognitive-behavioral principles to improve skills in stress appraisal, coping decisions, and obtaining social support. Participants will complete telephone-based surveys at three different assessment points measuring the prevalence of comorbid health conditions, cognitive functioning, life-stressor burden, ways of coping, coping self-efficacy, psychiatric distress, quality of life, and perceptions of social support. An initial test of the intervention with 40 participants, followed by a cross-validation of the intervention with a second group of 40 older adults, will assess the effectiveness of the telephone-delivered coping improvement intervention. In addition to providing a preliminary test of the intervention, study data will inform the development of an application to NIH to conduct a Phase III clinical trial of a telephone-delivered, coping improvement group intervention for the emotionally-vulnerable group of depressed older adults living with HIV infection.