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First published online June 9, 2020

Feasibility, acceptability, and preliminary impact of telemedicine-administered cognitive behavioral therapy for adherence and depression among African American women living with HIV in the rural South

Abstract

Women living with HIV are disproportionally affected by depression and mental healthcare access. A pilot feasibility trial using videoconferencing compared cognitive behavioral therapy for antiretroviral therapy adherence and depression (N = 11) to supportive psychotherapy (N = 11). Participants completed 10–12 weekly therapy sessions and 6-month follow-up. Retention at 6 months was 95 percent. Depression symptoms significantly decreased in both arms; antiretroviral therapy adherence remained high as measured via self-report and Wisepill. Satisfaction with intervention components was high; videoconferencing was highly acceptable and comparable to face-to-face counseling. This study demonstrates the feasibility of telemedicine-administered psychotherapy addressing mental health needs among women living with HIV.

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References

Ammassari A, Antinori A, Aloisi MS, et al. (2004) Depressive symptoms, neurocognitive impairment, and adherence to highly active antiretroviral therapy among HIV-infected persons. Psychosomatics 45: 394–402.
Andrinopoulos K, Clum G, Murphy DA, et al. (2011) Health related quality of life and psychosocial correlates among HIV-infected adolescent and young adult women in the US. AIDS Education and Prevention 23: 367–381.
Attkisson C (1982) The Client Satisfaction Questionnaire: Psychometric properties and correlations with service utilization and psychotherapy outcome. Evaluation and Program Planning 5: 233.
Benavides-Vaello S, Strode A, Sheeran B (2013) Using technology in the delivery of mental health and substance abuse treatment in rural communities: A review. The Journal of Behavioral Health Services & Research 40: 111–120.
Bhatia R, Hartman C, Kallen MA, et al. (2011) Persons newly diagnosed with HIV infection are at high risk for depression and poor linkage to care: Results from the steps study. AIDS and Behavior 15: 1161–1170.
Bing EG, Burnam MA, Longshore D, et al. (2001) Psychiatric disorders and drug use among human immunodeficiency virus-infected adults in the United States. Archives of General Psychiatry 58: 721–728.
Bouhnik AD, Preau M, Vincent E, et al. (2005) Depression and clinical progression in HIV-infected drug users treated with highly active antiretroviral therapy. Antiviral Therapy 10: 53–61.
Braun SR, Gregor B, Tran US (2013) Comparing bona fide psychotherapies of depression in adults with two meta-analytical approaches. PLoS ONE 8: e68135.
Brody DJ, Pratt LA, Hughes JP (2018) Prevalence of depression among adults aged 20 and over: United States, 2013-2016. NCHS Data Brief 303: 1–8.
Carrieri MP, Leport C, Protopopescu C, et al. (2006) Factors associated with nonadherence to highly active antiretroviral therapy: A 5-year follow-up analysis with correction for the bias induced by missing data in the treatment maintenance phase. Journal of Acquired Immune Deficiency Syndromes 41: 477–485.
Castleberry A (2014) NVivo 10 [software program]. Version 10. QSR International; 2012. American Journal of Pharmaceutical Education 78: 25.
Catz SL, Kelly JA, Bogart LM, et al. (2000) Patterns, correlates, and barriers to medication adherence among persons prescribed new treatments for HIV disease. Health Psychology: Official Journal of the Division of Health Psychology 19: 124–133.
CDC (2010) Current depression among adults—United States, 2006 and 2008. MMWR 59: 1229–1235.
Chesney MA, Chambers DB, Ickovics JR, et al. (2000) Self-reported adherence to antiretroviral medications among participants in HIV clinical trials: The AACTG adherence instruments. AIDS Care 12: 255–266.
Cohen J (1988) Statistical Power Analysis for the Behavioral Sciences (2nd edn). Hillsdale, NJ: Lawrence Erlbaum.
Cook JA, Grey D, Burke J, et al. (2004) Depressive symptoms and AIDS-related mortality among a multisite cohort of HIV-positive women. American Journal of Public Health 94: 1133–1140.
Cuiipers P, Straten A, Andersson G, et al. (2008) Psychotherapy for depression in adults: A meta-analysis of comparative outcome studies. Journal of Consulting and Clinical Psychology 76: 909–922.
Dalessandro M, Conti CM, Gambi F, et al. (2007) Antidepressant therapy can improve adherence to antiretroviral regimens among HIV-infected and depressed patients. Journal of Clinical Psychopharmacology 27: 58–61.
Davies EB, Morriss R, Glazebrook C (2014) Computer-delivered and web-based interventions to improve depression, anxiety, and psychological well-being of university students: A systematic review and meta-analysis. Journal of Medical Internet Research 16: e130.
Do AN, Rosenberg ES, Sullivan PS, et al. (2014) Excess burden of depression among HIV-infected persons receiving medical care in the United States: Data from the medical monitoring project and the behavioral risk factor surveillance system. PLoS ONE 9: e92842.
Dobkin RD, Interian A, Durland JL, et al. (2018) Personalized telemedicine for depression in Parkinson’s disease: A pilot trial. Journal of Geriatric Psychiatry and Neurology 31: 171–176.
Egede LE, Acierno R, Knapp RG, et al. (2015) Psychotherapy for depression in older veterans via telemedicine: A randomised, open-label, non-inferiority trial. The Lancet Psychiatry 2: 693–701.
Farinpour R, Miller EN, Satz P, et al. (2003) Psychosocial risk factors of HIV morbidity and mortality: Findings from the Multicenter AIDS Cohort Study (MACS). Journal of Clinical and Experimental Neuropsychology 25: 654–670.
Gidora H, Borycki EM, Kushniruk AW (2019) Effects of telenursing triage and advice on healthcare costs and resource use. Studies in Health Technology and Informatics 257: 133–139.
Gonzalez JS, Batchelder AW, Psaros C, et al. (2011) Depression and HIV/AIDS treatment nonadherence: A review and meta-analysis. Journal of Acquired Immune Deficiency Syndromes 58: 181–187.
Heckman TG, Somlai AM, Peters J, et al. (1998) Barriers to care among persons living with HIV/AIDS in urban and rural areas. AIDS Care 10: 365–375.
Himelhoch S, Mohr D, Maxfield J, et al. (2011) Feasibility of telephone-based cognitive behavioral therapy targeting major depression among urban dwelling African-American people with co-occurring HIV. Psychology, Health & Medicine 16: 156–165.
Hodder SL, Justman J, Hughes JP, et al. (2013) HIV acquisition among women from selected areas of the United States: A cohort study. Annals of Internal Medicine 158: 10–18.
Junkins A, Azuero A, Ott C, et al. (2019) Center for Epidemiological Studies-Depression Scale: Evaluation of a new cutoff score for women living with HIV. AIDS Patient Care and STDs 33: 343–345.
Kempf MC, Huang CH, Savage R, et al. (2015) Technology-delivered mental health interventions for people living with HIV/AIDS (PLWHA): A review of recent advances. Current HIV/AIDS Reports 12: 472–480.
Kempf MC, McLeod J, Boehme AK, et al. (2010) A qualitative study of the barriers and facilitators to retention-in-care among HIV-positive women in the rural southeastern United States: Implications for targeted interventions. AIDS Patient Care and STDs 24: 515–520.
Leon AC, Davis LL, Kraemer HC (2011) The role and interpretation of pilot studies in clinical research. Journal of Psychiatric Research 45: 626–629.
Lorentz MM (2008) Telenursing and home healthcare. the many facets of technology. Home Healthcare Nurse 26: 237–243.
Moneyham L, McLeod J, Boehme A, et al. (2010) Perceived barriers to HIV care among HIV-infected women in the deep South. Journal of the Association of Nurses in AIDS Care 21: 467–477.
Mugavero M, Ostermann J, Whetten K, et al. (2006) Barriers to antiretroviral adherence: The importance of depression, abuse, and other traumatic events. AIDS Patient Care and STDs 20: 418–428.
Murphy DA, Wilson CM, Durako SJ, et al. (2001) Antiretroviral medication adherence among the REACH HIV-infected adolescent cohort in the USA. AIDS Care 13: 27–40.
Nair U, Armfield NR, Chatfield MD, et al. (2018) The effectiveness of telemedicine interventions to address maternal depression: A systematic review and meta-analysis. Journal of Telemedicine and Telecare 24: 639–650.
Nanni MG, Caruso R, Mitchell AJ, et al. (2015) Depression in HIV infected patients: A review. Current Psychiatry Reports 17: 530.
Paterson DL, Swindells S, Mohr J, et al. (2000) Adherence to protease inhibitor therapy and outcomes in patients with HIV infection. Annals of Internal Medicine 133: 21–30.
Pellowski JA (2014) Barriers to care for rural people living with HIV: A review of domestic research and health care models. The Journal of the Association of Nurses in AIDS Care 24: 422–437.
Pence BW, Miller WC, Whetten K, et al. (2006) Prevalence of DSM-IV-defined mood, anxiety, and substance use disorders in an HIV clinic in the Southeastern United States. Journal of Acquired Immune Deficiency Syndromes 42: 298–306.
Rabkin JG (2008) HIV and depression: 2008 review and update. Current HIV/AIDS Reports 5: 163–171.
Radloff LS (1977) The CES-D Scale: A Self-Report Depression Scale for research in the general population. Applied Psychological Measurement 1: 385–401.
Reif S, Geonnotti KL, Whetten K (2006) HIV infection and AIDS in the deep South. American Journal of Public Health 96: 970–973.
Roberts KJ, Mann T (2000) Barriers to antiretroviral medication adherence in HIV-infected women. AIDS Care 12: 377–386.
Robertson K, Bayon C, Molina JM, et al. (2014) Screening for neurocognitive impairment, depression, and anxiety in HIV-infected patients in Western Europe and Canada. AIDS Care 26: 1555–1561.
Rohland BM (2001) Telepsychiatry in the heartland: If we build it, will they come? Community Mental Health Journal 37: 449–459.
Rosenthal R, Rubin DB (2003) R-equivalent: A simple effect size indicator. Psychological Methods 8: 492–496.
Rush KL, Howlett L, Munro A, et al. (2018) Videoconference compared to telephone in healthcare delivery: A systematic review. International Journal of Medical Informatics 118: 44–53.
Safren SA, Bedoya CA, O’Cleirigh C, et al. (2016) Cognitive behavioural therapy for adherence and depression in patients with HIV: A three-arm randomised controlled trial. Lancet HIV 3: e529–538.
Safren SA, O’Cleirigh C, Tan JY, et al. (2009) A randomized controlled trial of cognitive behavioral therapy for adherence and depression (CBT-AD) in HIV-infected individuals. Health Psychology: Official Journal of the Division of Health Psychology 28: 1–10.
Safren SA, O’Cleirigh CM, Bullis JR, et al. (2012) Cognitive behavioral therapy for adherence and depression (CBT-AD) in HIV-infected injection drug users: A randomized controlled trial. Journal of Consulting and Clinical Psychology 80: 404–415.
Safren SA, Otto M, Worth J (1999) Life steps: Applying cognitive behavioral therapy to HIV medication adherence. Cognitive and Behavioral Practice 6: 332–341.
Schumacher JE, McCullumsmith C, Mugavero MJ, et al. (2013) Routine depression screening in an HIV clinic cohort identifies patients with complex psychiatric co-morbidities who show significant response to treatment. AIDS and Behavior 17: 2781–2791.
Sherr L, Clucas C, Harding R, et al. (2011) HIV and depression—A systematic review of interventions. Psychology, Health & Medicine 16: 493–527.
Stringer KL, Azuero A, Ott C, et al. (2019) Feasibility and acceptability of real-time antiretroviral adherence monitoring among depressed women living with HIV in the deep South of the US. AIDS and Behavior 23: 1306–1314.
Swinton JJ, Robinson WD, Bischoff RJ (2009) Telehealth and rural depression: Physician and patient perspectives. Families, Systems & Health: The Journal of Collaborative Family Healthcare 27: 172–182.
Turner BJ, Laine C, Cosler L, et al. (2003) Relationship of gender, depression, and health care delivery with antiretroviral adherence in HIV-infected drug users. Journal of General Internal Medicine 18: 248–257.
Vandelanotte C, De Bourdeaudhuji I (2003) Acceptability and feasibility of a computer-tailored physical activity intervention using stages of change: Project FAITH. Health Education Research 18: 304–317.
Vyavaharkar M, Moneyham L, Murdaugh C, et al. (2012) Factors associated with quality of life among rural women with HIV disease. AIDS and Behavior 16: 295–303.
Wampold BE, Minami T, Baskin TW, et al. (2002) A meta-(re)analysis of the effects of cognitive therapy versus “other therapies” for depression. Journal of Affective Disorders 68: 159–165.
Xu T, Pujara S, Sutton S, et al. (2018) Telemedicine in the management of type 1 diabetes. Preventing Chronic Disease 15: E13.

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Published In

Article first published online: June 9, 2020
Issue published: December 2021

Keywords

  1. adherence
  2. cognitive behavioral therapy
  3. depression
  4. HIV
  5. women’s health

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© The Author(s) 2020.
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PubMed: 32515245

Authors

Affiliations

Anna Junkins
The University of Alabama at Birmingham, USA
Christina Psaros
Massachusetts General Hospital, USA
Harvard Medical School, USA
Corilyn Ott
The University of Alabama at Birmingham, USA
Andres Azuero
The University of Alabama at Birmingham, USA
Crystal Chapman Lambert
The University of Alabama at Birmingham, USA
Karen Cropsey
The University of Alabama at Birmingham, USA
Robert Savage
The University of Alabama at Birmingham, USA
Jessica E Haberer
Massachusetts General Hospital, USA
Harvard Medical School, USA
Steven A Safren
University of Miami, USA
Mirjam-Colette Kempf
The University of Alabama at Birmingham, USA

Notes

Mirjam-Colette Kempf, PhD, MPH, The University of Alabama at Birmingham, 1701 University Boulevard, Birmingham, AL 35294-1210, USA. Email: [email protected]

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