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Mindfulness-Based Interventions for Adults Living with HIV/AIDS: A Systematic Review and Meta-analysis

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Abstract

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 = 1059; M age = 42 years; 20% women). Participants had been living with HIV for an average of 8 years (range = < 1–20 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.

Resumen

Este metaanálisis examinó los efectos de las intervenciones basadas en la atención plena (MBI) sobre el estrés, los síntomas psicológicos y los biomarcadores de enfermedades entre las personas que viven con VIH/SIDA. Las búsquedas exhaustivas identificaron 16 estudios que cumplieron con los criterios de inclusión (N = 1059; M edad = 42 años, 20% mujeres). Los participantes habían estado viviendo con VIH durante un promedio de 8 años (rango = < 1 a 20 años); el 65% estaba actualmente en tratamiento antirretroviral. Los análisis entre grupos indicaron que los síntomas depresivos se redujeron entre los participantes que recibieron los MBI en comparación con los controles (d+ = 0.37; 95% CI 0.03, 0.71). Los análisis dentro del grupo mostraron reducciones en los síntomas psicológicos (es decir, menos ansiedad, menos síntomas depresivos) y una mejor calidad de vida con el tiempo entre los participantes con MBI (d+s = 0.40–0.85). No se observaron cambios significativos en los resultados inmunológicos (es decir, recuentos de CD4) entre grupos o dentro de ellos. Los MBI pueden ser un enfoque prometedor para reducir los síntomas psicológicos y mejorar la calidad de vida entre las personas que viven con VIH/SIDA. Se necesitan estudios que utilicen diseños más fuertes (es decir, ensayos controlados aleatorios) con tamaños de muestra más grandes y seguimientos más largos para aclarar los beneficios potenciales de los MBI para personas que viven con VIH/SIDA.

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Notes

  1. Creswell et al. [54 used a brief version of MBSR as the comparison condition. Therefore, within-group analyses included this comparison condition as a MBI rather than a control. The pattern of results did not change when the brief MBSR condition was included as a control condition (data not shown).

  2. Wood [49] assessed but did not report CD4 + counts at baseline.

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Acknowledgements

We thank Bill Gayner, MSW, RSW, and Jessica Robinson-Papp, MD who provided additional intervention details or data from their studies.

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Funding

The research reported in this paper was supported by the National Center for Complementary and Integrative Health of the National Institutes of Health under award number R01AT008815 to Lori A. J. Scott-Sheldon, PhD and Michael P. Carey, PhD (Multiple PIs). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

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Correspondence to Lori A. J. Scott-Sheldon.

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Scott-Sheldon, L.A.J., Balletto, B.L., Donahue, M.L. et al. Mindfulness-Based Interventions for Adults Living with HIV/AIDS: A Systematic Review and Meta-analysis. AIDS Behav 23, 60–75 (2019). https://doi.org/10.1007/s10461-018-2236-9

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