Improve the Psychological Well-Being of Patients Living with HIV/AIDS with Mindfulness
By John M. de Castro, Ph.D.
“Given the stress-reduction benefits of mindfulness meditation training, these findings indicate there can be health protective effects not just in people with HIV but in folks who suffer from daily stress,” – – David Creswell
More than 35 million people worldwide and 1.2 million people in the United States are living with HIV infection. These include a significant number of children and adolescents. In 1996, the advent of the protease inhibitor and the so-called cocktail changed the prognosis for HIV. Since this development a 20-year-old infected with HIV can now expect to live on average to age 69. Hence, living with HIV is a long-term reality for a very large group of people.
People living with HIV infection experience a wide array of physical and psychological symptoms which decrease their perceived quality of life. The symptoms include chronic pain, muscle aches, anxiety, depression, weakness, fear/worries, difficulty with concentration, concerns regarding the need to interact with a complex healthcare system, stigma, and the challenge to come to terms with a new identity as someone living with HIV. Mindfulness training has been shown to improve psychological well-being, lower depression and strengthen the immune system of patients with HIV infection. Yoga practice has also been found to be effective in treating HIV.
The research is accumulating. So, it makes sense to step back and review what has been learned about the effectiveness of mindfulness training for the treatment of the symptoms of living with HIV/AIDS. In today’s Research News article “Mindfulness-Based Interventions for Adults Living with HIV/AIDS: A Systematic Review and Meta-analysis.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6344266/), Scott-Sheldon and colleagues review, summarize, and perform a meta-analysis of the effectiveness of Mindfulness-Based Interventions (MBIs) for the treatment of the symptoms experienced by people living with HIV/AIDS.
They identified 16 published research studies containing a total of 1059 participants. Of these studies 11 employed Mindfulness-Based Stress Reduction (MBSR) while 5 studies employed Mindfulness-Based Cognitive Therapy (MBCT). All studies compared pre- to post-treatment measures while 9 of these studies also had a control comparison group.
They report that the published research found that in comparison to baseline after treatment with Mindfulness-Based Interventions (MBIs) there were significant improvements in quality of life and positive emotions and significant reductions in anxiety and depression. The reductions in depression were significantly greater for those participants who received Mindfulness-Based Cognitive Therapy (MBCT). No significant effects were reported for improvements in immune system function (CD4 counts).
This analysis of the available research suggests that Mindfulness-Based Interventions (MBIs) are a safe and effective treatment to improve the psychological health of patients diagnosed with HIV/AIDS. The fact that Mindfulness-Based Cognitive Therapy (MBCT) was more effective for depression was not surprising as MBCT was specifically developed to treat depression. It has been well established the Mindfulness-Based Interventions (MBIs) are effective in reducing anxiety and depression and improving positive emotions and quality of life in a wide variety of patients. The present analysis simply extends types of patients for which Mindfulness-Based Interventions (MBIs)are beneficial to patients diagnosed with HIV/AIDS.
So, improve the psychological well-being of patients living with HIV/AIDS with mindfulness.
“mindfulness-based therapies . . . had a long-term effect on stress and both a short- and long-term effect on depression in people living with an HIV infection.” – Xu Tian
CMCS – Center for Mindfulness and Contemplative Studies
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Scott-Sheldon, L., Balletto, B. L., Donahue, M. L., Feulner, M. M., Cruess, D. G., Salmoirago-Blotcher, E., … Carey, M. P. (2019). Mindfulness-Based Interventions for Adults Living with HIV/AIDS: A Systematic Review and Meta-analysis. AIDS and behavior, 23(1), 60–75. doi:10.1007/s10461-018-2236-9
This meta-analysis examined the effects of mindfulness-based interventions (MBIs) on stress, psychological symptoms, and biomarkers of disease among people living with HIV/AIDS (PLWHA). Comprehensive searches identified 16 studies that met the inclusion criteria (N = 1,059; M age = 42 years; 20% women). Participants had been living with HIV for an average of 8 years (range = <1 to 20 years); 65% were currently on antiretroviral therapy. Between-group analyses indicated that depressive symptoms were reduced among participants receiving the MBIs compared to controls (d+ = 0.37, 95% CI = 0.03, 0.71). Within-group analyses showed reductions in psychological symptoms (i.e., less anxiety, fewer depressive symptoms) and improved quality of life over time among MBI participants (d+s = 0.40–0.85). No significant changes were observed for immunological outcomes (i.e., CD4 counts) between- or within- groups. MBIs may be a promising approach for reducing psychological symptoms and improving quality of life among PLWHA. Studies using stronger designs (i.e., randomized controlled trials) with larger sample sizes and longer follow-ups are needed to clarify the potential benefits of MBIs for PLWHA.