Exploring Mediators of a Guided Web-Based Self-Help Intervention for People With HIV and Depressive Symptoms:...

Area of Science:

• Mental Health
• HIV/AIDS Research
• Digital Therapeutics

Background:

• Cognitive behavioral therapy (CBT) is a common treatment for depressive symptoms in individuals with HIV.
• An internet-based CBT intervention was developed from an effective self-help booklet for this population.
• This Web-based intervention has previously demonstrated effectiveness.

Purpose of the Study:

• To identify the specific factors that mediate the effects of the Web-based CBT intervention.
• To understand the mechanisms through which the intervention impacts depressive symptoms in people with HIV.

Main Methods:

• A randomized controlled trial compared the Web-based CBT intervention to an attention-only control group.
• 188 participants with HIV and mild to moderate depressive symptoms were recruited.
• Potential mediators including behavioral activation, goal re-engagement, and coping self-efficacy were assessed using Web-based questionnaires.

Main Results:

• Changes in behavioral activation and goal re-engagement were identified as significant mediators of the intervention's effect.
• Behavioral activation mediated the intervention effect between weeks 3-5.
• Goal re-engagement mediated the intervention effect between weeks 1-3, with a stronger overall mediation effect observed for behavioral activation.

Conclusions:

• The Web-based CBT intervention for people with HIV and depressive symptoms appears to work through improvements in behavioral activation and goal re-engagement.
• Identifying these mediators can inform the refinement of therapeutic strategies and enhance treatment outcomes.