Self-efficacy and distress in women with AIDS: the SMART/EST women's project

AIDS Care. 2010 Dec;22(12):1499-508. doi: 10.1080/09540121.2010.484454.


Though African American and Hispanic women accounted for 14% of the female population in the USA, they represented 66% of the total HIV/AIDS diagnoses among women in 2007. Among men living with HIV, increased coping self-efficacy (SE) following a cognitive behavioral intervention has been related to decreased distress, anxiety, anger, and confusion, but comparable studies had not been carried out with HIV+ women. The purpose of this study was to examine the impact of changes in SE following a cognitive behavioral stress management plus expressive supportive therapy (CBSM+) intervention on depression and anxiety in low-income urban predominantly minority women living with AIDS. Women (n=451) were randomized to a group CBSM+ or individual informational intervention condition and completed baseline, post-intervention and long-term follow-up (12 months) assessments of depression, anxiety and SE. Women who were assigned to the CBSM+ group condition and increased their level of cognitive behavioral SE reported significant decreases in anxiety and depression at post-intervention and long-term follow-up in comparison with controls who did not improve. Results suggest that both cognitive behavioral skills and a concomitant increase in the perceived level of SE in the use of those skills are predictive of distress reduction.

Publication types

  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural

MeSH terms

  • Acquired Immunodeficiency Syndrome / ethnology
  • Acquired Immunodeficiency Syndrome / psychology*
  • Acquired Immunodeficiency Syndrome / therapy
  • Adaptation, Psychological
  • Adult
  • Algorithms
  • Anti-HIV Agents / therapeutic use*
  • Cognitive Behavioral Therapy / methods*
  • Female
  • Humans
  • Middle Aged
  • Psychotherapy, Group / methods*
  • Self Efficacy*
  • Social Support
  • Socioeconomic Factors
  • Statistics as Topic
  • Stress, Psychological / etiology*
  • Stress, Psychological / therapy
  • United States
  • Women's Health


  • Anti-HIV Agents