Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #114533

Warren Passin, MPH, MSW¹, Nicole Crepaz, PhD¹, Sima Rama, MPH¹, Jeffrey H. Herbst, PhD², Cynthia M. Lyles, PhD², Ron Stall, PhD, MPH¹, and Robert Malow, PhD³. (1) NCHSTP, Division of HIV/AIDS Prevention, Prevention Research Branch, Centers for Disease Control and Prevention, 1600 Clifton Road NE, Mailstop E37, Atlanta, GA 30333, (404) 639-6481, wpassin@cdc.gov, (2) Division of HIV/AIDS Prevention, CDC, 1600 Clifton Road, Mailstop E37, Atlanta, GA 30333, (3) Robert Stempel School of Public Health/ AIDS Prevention Program, Florida International University, 3000 N.E. 151 Street, ACI-260, North Miami, FL 33181

BACKGROUND: Evidence suggests prevalence of depression is higher among people living with HIV/AIDS (PLWHA) than the general population, and depression is significantly associated with AIDS-related mortality. We conducted a meta-analysis to evaluate the effects of cognitive behavioral interventions (CBIs) for reducing depression and improving immune function of PLWHA.

METHODS: Systematic searches were used to identify relevant studies. Inclusion criteria are: 1) CBIs targeting PLWHA; 2) controlled trials with a comparison group; and 3) evaluation of depression or immune system function (measured by CD3/CD8, CD4, or NK cell levels). Effect sizes (ESs) were estimated with odds ratios (ORs), and fixed-effects models were used to aggregate the data due to the homogeneity of the ESs.

RESULTS: Eleven controlled trials met the inclusion criteria. Overall, CBIs had a significant impact in reducing depression (OR = 0.64; 95% CI: 0.45, 0.89; 9 ESs) and improving immune function (OR=1.52; 95% CI: 1.08, 2.13; 9 ESs). These significant effects were observed in studies with PLWHA on highly active antiretroviral therapy (HAART), but not in studies where PHLHA were not on HAART. Significant improvement of immune function was seen in CBIs delivered in groups while a significant decrease of depression symptoms was seen in CBIs delivered to individuals.

CONCLUSIONS: CBIs are efficacious in reducing depression and improving immune function of PLWHA, especially in PLWHA taking HAART. Further research is needed to assess the relationship among depression, adherence to HAART, and immune function and differential impact of group and individual level CBIs on depression and immune function.

Learning Objectives: At the conclusion of the session, the attendees at this session will be able to

• Understand the impact of depression among people living with HIV/AIDS and the importance addressing mental health concerns in this pouplation.
• Assess the effects of cognitive-behavioral interventions on reducing depression in people living with HIV/AIDS.
• Assess the effects of cognitive-behavioral interventions on the immune function in people living with HIV/AIDS.

Keywords: HIV/AIDS, Depression

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.

Recorded presentation