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Despite the recent growth of mindfulness research worldwide, there remains little research examining the application of mindfulness-based interventions in resource-limited, international settings. This study examined the application of Mindfulness-Based Stress Reduction (MBSR) for HIV-infected individuals in South Africa, where rates of HIV are highest in the world. Mixed methods were used to examine the following over a three-month follow-up: (1) feasibility, acceptability, and preliminary adaptation of MBSR for this new context; and (2) effects of MBSR on immune functioning, self-reported mindfulness (MAAS, FFMQ), depression, anxiety, and stress (DASS-21). Ten individuals initiated MBSR, and seven completed all eight sessions. Results indicated medium effect size improvements in immune functioning (CD4 count and T cell count; d = .5) through the three-month follow-up, though the small sample size limited power to detect a statistically significant effect. From baseline to post-treatment, improvements in “Observing” and “Non-reactivity” (FFMQ) approached statistical significance with large effect sizes (observing: d = 1.5; p = .08; non-reactivity: d = .7; p = .07). There were no statistically significant changes in depression, anxiety, or stress throughout the study period. Primary areas for adaptation of MBSR included emphasis on informal practice, ways to create “space” without much privacy, and ways to concretize the concepts and definitions of mindfulness. Feedback from participants can shape future adaptations to MBSR for this and similar populations. Findings provide preliminary evidence regarding the implementation of MBSR for individuals living with HIV in South Africa. A future randomized clinical trial with a larger sample size is warranted.
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Andersen, L. S., Magidson, J. F., O’Cleirigh, C., Remmert, J. E., Kagee, A., Leaver, M., et al. (2016). A pilot study of a nurse-delivered cognitive behavioral therapy intervention (Ziphamandla) for adherence and depression in HIV in South Africa. Journal of Health Psychology.https://doi.org/10.1177/1359105316643375.
AVERT. (2013). South Africa HIV and Aids Statistics. Retrieved from https://www.avert.org/professionals/hiv-around-world/sub-saharan-africa/south-africa.
Baer, R. A. (2003). Mindfulness training as a clinical intervention: A conceptual and empirical review. Clinical Psychology: Science and Practice, 10(2), 125–143. https://doi.org/10.1093/clipsy.bpg015.
Brandt, R. (2009). The mental health of people living with HIV/AIDS in Africa: a systematic review. African Journal of AIDS Research, 8(2), 123–133. https://doi.org/10.2989/AJAR.2009.8.2.1.853. CrossRefPubMed
Brown, J. L., & Vanable, P. A. (2008). Cognitive-behavioral stress management interventions for persons living with HIV: a review and critique of the literature. Annals of Behavioral Medicine: A Publication of the Society of Behavioral Medicine, 35(1), 26–40. https://doi.org/10.1007/s12160-007-9010-y. CrossRef
Cohen, J. (1988). Statistical power analysis for the behavioral sciences. New York, NY: Routledge Academic.
Creswell, J. D., Myers H. F., Cole, S. W., & Irwin, M. R. (2009). Mindfulness meditation training effects on CD4+ T lymphocytes in HIV-1 infected adults: a small randomized controlled trial. Brain, Behavior, and Immunity, 23(2), 184–188. https://doi.org/10.1016/j.bbi.2008.07.004.
Curran, G. M., Bauer, M., Mittman, B., Pyne, J. M., & Stetler, C. (2012). Effectiveness-implementation hybrid designs: combining elements of clinical effectiveness and implementation research to enhance public health impact. Medical Care, 50(3), 217–226. https://doi.org/10.1097/MLR.0b013e3182408812. CrossRefPubMedPubMedCentral
Delaney, E., & O’Brien, W. H. (2012). The association between acceptance and mental health while living with HIV. Social Work in Mental Health, 10(3), 253–266. https://doi.org/10.1080/15332985.2011.649107. CrossRef
Fuchs, C., Lee, J. K., Roemer, L., & Orsillo, S. M. (2013). Using mindfulness- and acceptance-based treatments with clients from nondominant cultural and/or marginalized backgrounds: clinical considerations, meta-analysis findings, and introduction to the special series. Cognitive and Behavioral Practice, 20(1), 1–12. https://doi.org/10.1016/j.cbpra.2011.12.004. CrossRefPubMedPubMedCentral
Gayner, B., Esplen, M. J., DeRoche, P., Wong, J., Bishop, S., Kavanagh, L., & Butler, K. (2012). A randomized controlled trial of mindfulness-based stress reduction to manage affective symptoms and improve quality of life in gay men living with HIV. Journal of Behavioral Medicine, 35(3), 272–285. https://doi.org/10.1007/s10865-011-9350-8. CrossRefPubMed
Gonzalez-Garcia, M., Ferrer, M. J., Borras, X., Muñoz-Moreno, J. A., Miranda, C., Puig, J., et al. (2014). Effectiveness of mindfulness-based cognitive therapy on the quality of life, emotional status, and CD4 cell count of patients aging with HIV infection. AIDS and Behavior, 18(4), 676–685. https://doi.org/10.1007/s10461-013-0612-z. CrossRefPubMed
Hoffmann, C., & Kamps, B. S. (2007). HIV medicine. Paris: Flying Publisher.
Jam, S., Imani, A. H., Foroughi, M., SeyedAlinaghi, S., Koochak, H. E., & Mohraz, M. (2010). The effects of mindfulness-based stress reduction (MBSR) program in Iranian HIV/AIDS patients: a pilot study. Acta Medica Iranica, 48(2), 101–106. PubMed
Kabat-Zinn, J. (2013). Full catastrophe living: using the wisdom of your body and mind to face stress, pain, and illness (Revised and updated edition). New York: Bantam Books trade paperback.
Kok, R. (2011). Exploring mindfulness in self-injuring adolescents in a psychiatric setting. Journal of Pscyhology in Africa, 21(2), 185–196. CrossRef
Kretchy, I. A., Owusu-Daaku, F. T., & Danquah, S. A. (2014). Mental health in hypertension: assessing symptoms of anxiety, depression and stress on anti-hypertensive medication adherence. International Journal of Mental Health Systems, 8, 25. https://doi.org/10.1186/1752-4458-8-25. CrossRefPubMedPubMedCentral
Magidson, J. F., Gouse, H., Psaros, C., Remmert, J. E., O’Cleirigh, C., & Safren, S. A. (2017). Task shifting and delivery of behavioral medicine interventions in resource poor global settings: HIV/AIDS treatment in Sub-Saharan Africa. In A. Vranceanu, J. Greer, & S. Safren (Eds.), Massachusetts General Hospital (MGH) Handbook of Behavioral Medicine (pp. 297–320). New York: Springer. CrossRef
Moitra, E., Herbert, J. D., & Forman, E. M. (2011). Acceptance-based behavior therapy to promote HIV medication adherence. AIDS Care, 23(12), 1660–1667. https://doi.org/10.1080/09540121.2011.579945. CrossRefPubMed
Nell, W. (2016). Mindfulness and psychological well-being among black South African university students and their relatives. Journal of Psychology in Africa, 26(6), 485–490. https://doi.org/10.1080/14330237.2016.1250419. CrossRef
Olagunju, A. T., Ogundipe, O. A., Erinfolami, A. R., Akinbode, A. A., & Adeyemi, J. D. (2013). Toward the integration of comprehensive mental health services in HIV care: an assessment of psychiatric morbidity among HIV-positive individuals in sub-Saharan Africa. AIDS Care, 25(9), 1193–1198. https://doi.org/10.1080/09540121.2013.763892. CrossRefPubMed
Olley, B. O., Zeier, M. D., Seedat, S., & Stein, D. J. (2005). Post-traumatic stress disorder among recently diagnosed patients with HIV/AIDS in South Africa. AIDS Care, 17(5), 550–557. https://doi.org/10.1080/09540120412331319741. CrossRefPubMed
Proctor, E., Silmere, H., Raghavan, R., Hovmand, P., Aarons, G., Bunger, A., et al. (2011). Outcomes for implementation research: conceptual distinctions, measurement challenges, and research agenda. Administration and Policy in Mental Health and Mental Health Services Research, 38(2), 65–76. CrossRefPubMed
Riley, K. E., & Kalichman, S. (2015). Mindfulness-based stress reduction for people living with HIV/AIDS: Preliminary review of intervention trial methodologies and findings. Health Psychology Review, 9(2), 224–243. https://doi.org/10.1080/17437199.2014.895928. CrossRefPubMed
Scott-Sheldon, L. A. J., Kalichman, S. C., Carey, M. P., & Fielder, R. L. (2008). Stress management interventions for HIV+ adults: a meta-analysis of randomized controlled trials, 1989 to 2006. Health Psychology: Official Journal of the Division of Health Psychology, American Psychological Association, 27(2), 129–139. https://doi.org/10.1037/0278-6220.127.116.11. CrossRef
SeyedAlinaghi, S., Jam, S., Foroughi, M., Imani, A., Mohraz, M., Djavid, G. E., & Black, D. S. (2012). Randomized controlled trial of mindfulness-based stress reduction delivered to human immunodeficiency virus-positive patients in Iran: Effects on CD4 + T lymphocyte count and medical and psychological symptoms. Psychosomatic Medicine, 74(6), 620–627. https://doi.org/10.1097/PSY.0b013e31825abfaa. CrossRefPubMedPubMedCentral
UNAIDS. (2014). 2014 Progress Report on the Global Plan. Retrieved from https://www.unaids.org/sites/default/files/documents/JC2681_2014-Global-Plan-progress_en.pdf.
Witek-Janusek, L., Albuquerque, K., Chroniak, K. R., Chroniak, C., Durazo-Arvizu, R., & Mathews, H. L. (2008). Effect of mindfulness based stress reduction on immune function, quality of life and coping in women newly diagnosed with early stage breast cancer. Brain, Behavior, and Immunity, 22(6), 969–981. https://doi.org/10.1016/j.bbi.2008.01.012. CrossRefPubMedPubMedCentral
- The Application of Mindfulness for Individuals Living with HIV in South Africa: a Hybrid Effectiveness-Implementation Pilot Study
Margo de Kooker
Jessica F. Magidson
- Springer US