Cognitive-behavioral stress management interventions for persons living with HIV: a review and critique of the literature

Ann Behav Med. 2008 Feb;35(1):26-40. doi: 10.1007/s12160-007-9010-y. Epub 2008 Feb 16.

Abstract

Background: Psychological adjustment and coping are central to human immunodeficiency virus (HIV) management. To improve HIV-infected patients' ability to cope with stress, a variety of stress management interventions have been designed and evaluated.

Purpose: This paper provides a review and critique of the stress management literature, including a: (1) synthesis of core components of interventions for HIV-infected people, (2) summary of stress, coping, psychological, and health outcomes, and (3) methodological critique and guidance for future research.

Methods: We reviewed 21 stress management interventions designed for HIV-infected individuals that included both cognitive and behavioral skills training.

Results: Most studies noted positive changes in perceived stress, depression, anxiety, global psychological functioning, social support, and quality of life. However, results were mixed for coping and health status outcomes, and a majority of studies employed only brief follow-up periods, focused on HIV-infected MSM, and did not address HIV-specific stressors.

Conclusions: Stress management interventions for HIV-infected persons are a promising approach to facilitate positive adjustment. However, this literature is limited by measurement problems, research design features, a narrow focus on HIV-infected men who have sex with men, and feasibility concerns for intervention dissemination. Future stress management interventions should address these limitations and the unique psychosocial needs of HIV-infected patients using briefer, more cost-effective formats.

Publication types

  • Research Support, N.I.H., Extramural
  • Review

MeSH terms

  • Adaptation, Psychological*
  • Behavior Therapy / methods*
  • Cognitive Behavioral Therapy / methods*
  • Female
  • HIV Infections / complications
  • HIV Infections / psychology*
  • Humans
  • Male
  • Outcome Assessment, Health Care
  • Stress, Psychological / etiology
  • Stress, Psychological / therapy*