An Initial Open Trial of a Brief Behavioral Activation Treatment for Depression and Medication Adherence in HIV-Infected Patients.
A single hour of behavioral activation can modestly cut depression and may help rural HIV patients stick to their medication.
01Research in Context
What this study did
Ten rural adults with HIV and depression got one 60-minute session of behavioral activation.
The session taught them to plan pleasant activities and link mood to taking their HIV meds.
Researchers checked depression, stress, and pill-taking before and one month later.
What they found
Depression and stress dropped by medium amounts, but the changes were not strong enough to be called significant.
Self-reported pill-taking went up by a similar medium amount.
All ten people finished the study, so the short format was doable.
How this fits with other research
Neely et al. (2021) reviewed telehealth BA and said it works for skill-building. T et al. used in-person delivery, so the review still backs the method even if the setting differs.
Hong et al. (2021) used the same BA steps with a teen who has Down syndrome and saw full remission in six weeks. The teen got hybrid telehealth, showing BA can travel across ages and diagnoses.
Lightfoot et al. (2007) ran peer groups for HIV-positive youth. Their work and this study both serve people with HIV, but BA here is much shorter and targets mood plus meds, not peer skills.
Why it matters
If you serve adults with HIV who feel down and skip doses, one BA session is worth trying. It takes little time and may lift mood enough to keep them on their meds.
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02At a glance
03Original abstract
Advances in HIV treatment through highly active antiretroviral therapy (HAART) have led to a steady decline in HIV-related mortality rates. However, HAART requires adherence to strict and often complicated medication regimens, and nonadherence to HAART can significantly decrease its effectiveness. Depression has consistently shown a robust association with medication nonadherence; consequently, numerous psychological interventions have been developed to target depression and increase medication adherence among HIV-infected individuals. The length of these interventions, however, may be prohibitive for certain HIV-infected populations, such as patients in rural areas. Therefore, this study provides an initial investigation of a one-session behavioral activation treatment for depression designed specifically for HIV-infected patients (BATD-HIV) at a community infectious disease clinic serving a largely rural population. In this initial uncontrolled open trial, BATD-HIV was administered to 10 HIV-infected patients with elevated symptoms of depression following their clinic appointment. Depression, anxiety, and stress symptom severity; behavioral activation processes; medication adherence; and CD4 T-cell count were assessed pre- and 1 month postintervention. Participants exhibited significant reductions in anxiety symptom severity and avoidance of negative aversive states and rumination from pre- to 1 month posttreatment. Although nonsignificant, participants also showed medium effect size reductions in depression and stress symptoms and work/school and social impairment, and medium effect size improvements in medication adherence and CD4 T-cell counts. Despite the preliminary nature of this study, results suggest that BATD-HIV may have utility as a brief treatment for HIV-infected patients with depression and warrants further investigation in larger scale randomized controlled trials.
Behavior modification, 2018 · doi:10.1177/0145445517723901