Development and Implementation of an HIV and Anxiety Management/Reduction Program (HAMRT)
Brandt, Charles Philip
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The Human Immunodeficiency Virus (HIV) is a worldwide pandemic affecting over 35 million individuals worldwide. Though revolutions in antiretroviral medications can control the virus and enable infected individuals to live full lifespans with the disease, upwards of half of all persons living with HIV/AIDS (PLWHA) are not appropriately adherent to their medication. This underadherence leads to higher than expected rates of mortality, disease spread, and increasing the financial burden on the global healthcare system. Recent research has indicated that mental health disorders, particularly anxiety, predicts poor antiretroviral medication adherence. Despite this knowledge, there have not yet been treatments developed specifically to increase medication adherence via the reduction of anxiety among PLWHA. The present study aimed to fill in this gap by developing and implementing a six-session CBT-based integrated treatment/management program for PLWHA with concurrent anxiety that impedes success of HIV management. The recruited sample included 42 PLWHA (Mage = 46.95, SD = 9.93, range = 21-61, 45.2% female) who were randomized to either an active treatment condition, or a waitlist control condition of equal length. Participants were assessed pre-randomization, at the mid-treatment time point (after three sessions for the active participants and three weeks for the control participants) and post-treatment (six sessions for active participants, six weeks for control participants). Active participants were then re-assessed at 1-, 3-, and 6-months post-treatment. Attrition was high for the active condition (i.e., 73.2%). Results indicated notable effect sizes between the active and control conditions on most outcome variables including HIV medication adherence (Partial Eta Squared = .189), anxiety symptoms (Cohen’s D = .64), anxiety sensitivity (Cohen’s D = 1.5), Depressive symptoms (Cohen’s D = .8), and multiple quality of life indices (range of Cohen’s D = .43 – 1.73). These findings are discussed in terms of the feasibility and utility of administering an anxiety-reduction therapy program specifically designed for PLWHA with HIV medication adherence difficulties.