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Cognitive behavioral therapy for adherence and depression (CBT-AD) in HIV-infected injection drug users: a randomized

Steven A Safren1, Conall M O'Cleirigh, Jacqueline R Bullis

  • 1Massachusetts General Hospital. ssafren@partners.org

Journal of Consulting and Clinical Psychology
|May 2, 2012
PubMed

Insights

Cognitive Behavioral Therapy for Adherence and Depression (CBT-AD) improved adherence and depression in HIV patients with substance use disorders. Gains in depression were maintained post-treatment, but adherence benefits diminished without continued support.

Area of Science:

  • Clinical Psychology
  • Infectious Diseases
  • Addiction Medicine

Background:

  • HIV, depression, and substance use are common comorbidities impacting treatment adherence.
  • Injection drug use is prevalent among individuals with HIV globally.
  • Effective interventions are needed to manage these co-occurring conditions.

Purpose of the Study:

  • To evaluate the efficacy of Cognitive Behavioral Therapy for Adherence and Depression (CBT-AD) versus enhanced treatment as usual (ETAU).
  • To assess CBT-AD's impact on adherence and depression in patients with HIV, depression, and active injection drug use.
  • To examine outcomes at post-treatment and at 3- and 6-month follow-ups.

Main Methods:

  • A randomized controlled trial with 89 participants was conducted.
  • Two arms compared CBT-AD with ETAU.
  • Adherence was measured using MEMS, and depression via blinded assessments.

Main Results:

  • CBT-AD significantly improved adherence and reduced depression symptoms post-treatment compared to ETAU.
  • Depression improvements were sustained at follow-up, but adherence gains were not.
  • CBT-AD also led to significant improvements in CD4 cell counts over time.

Conclusions:

  • CBT-AD effectively integrates depression treatment with adherence interventions for complex HIV patients.
  • While CBT-AD shows initial benefits, ongoing adherence support is crucial for sustained gains.
  • This approach offers a valuable strategy for managing multifaceted health challenges in this population.
Abstract

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