Defense Date

9-9-2010

Graduation Date

Fall 2010

Availability

Immediate Access

Submission Type

dissertation

Degree Name

PhD

Department

Nursing

School

School of Nursing

Committee Chair

Linda Goodfellow

Committee Member

Mary Ann Thurkettle

Committee Member

Suzanne Willard

Keywords

Acquired immunodeficiency syndrome, Antiretroviral therapy, Cognitive-behavioral therapy, HIV, Psychoneuroimmunology, Side effects

Abstract

Background & Purpose: Antiretroviral therapy (ART) for HIV/AIDS has led to significant improvements in survival and a reduction in AIDS-related morbidity. Adherence to regimens is vital, yet clinical observations and research have suggested that side effects are a significant reason for non-adherence. This randomized, controlled clinical trial was a pilot study sought to determine if a brief exposure cognitive-behavioral therapy (CBT) could reduce side effect symptoms in HIV/AIDS patients on ART.

Methods: 33 participants were randomized to standard adherence education alone or adherence education plus three sessions of CBT over a period of three months.

Results: Completing the study were 17 males and one female; whites, blacks, and Hispanics were represented in the sample. Mean duration of ART was over 200 weeks. Participants in the experimental group reported significantly less nausea and fatigue, compared to those in the control group (Mann-Whitney U, p < .05). There were no differences in adherence across the study, which was reported at > 94%. No differences in CD4 lymphocyte counts or viral load were observed between groups over the course of the study.

Discussion: Brief exposure to CBT training in male HIV/AIDS patients on ART appears to reduce side effect symptoms. Observations suggested that scheduling visits with the psychologist delivering the CBT sessions was an obstacle to continued participation. The use of side effect reducing medication was low in both groups. Increasing daily practice sessions was correlated with an increase in reported nausea scores. The reason for this observation is not known. A larger sample with more female representation is warranted to explore this intervention further. Referral for CBT to reduce side effect symptoms in such patients may be warranted.

Format

PDF

Language

English

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