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
Restricted accessResearch articleFirst published online December, 2021
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
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.
AmmassariAAntinoriAAloisiMS, et al. (2004) Depressive symptoms, neurocognitive impairment, and adherence to highly active antiretroviral therapy among HIV-infected persons. Psychosomatics45: 394–402.
2.
AndrinopoulosKClumGMurphyDA, 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 Prevention23: 367–381.
3.
AttkissonC (1982) The Client Satisfaction Questionnaire: Psychometric properties and correlations with service utilization and psychotherapy outcome. Evaluation and Program Planning5: 233.
4.
Benavides-VaelloSStrodeASheeranB (2013) Using technology in the delivery of mental health and substance abuse treatment in rural communities: A review. The Journal of Behavioral Health Services & Research40: 111–120.
5.
BhatiaRHartmanCKallenMA, 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 Behavior15: 1161–1170.
6.
BingEGBurnamMALongshoreD, et al. (2001) Psychiatric disorders and drug use among human immunodeficiency virus-infected adults in the United States. Archives of General Psychiatry58: 721–728.
7.
BouhnikADPreauMVincentE, et al. (2005) Depression and clinical progression in HIV-infected drug users treated with highly active antiretroviral therapy. Antiviral Therapy10: 53–61.
8.
BraunSRGregorBTranUS (2013) Comparing bona fide psychotherapies of depression in adults with two meta-analytical approaches. PLoS ONE8: e68135.
9.
BrodyDJPrattLAHughesJP (2018) Prevalence of depression among adults aged 20 and over: United States, 2013-2016. NCHS Data Brief303: 1–8.
10.
CarrieriMPLeportCProtopopescuC, 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 Syndromes41: 477–485.
11.
CastleberryA (2014) NVivo 10 [software program]. Version 10. QSR International; 2012. American Journal of Pharmaceutical Education78: 25.
12.
CatzSLKellyJABogartLM, 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 Psychology19: 124–133.
13.
CDC (2010) Current depression among adults—United States, 2006 and 2008. MMWR59: 1229–1235.
ChesneyMAChambersDBIckovicsJR, et al. (2000) Self-reported adherence to antiretroviral medications among participants in HIV clinical trials: The AACTG adherence instruments. AIDS Care12: 255–266.
16.
CohenJ (1988) Statistical Power Analysis for the Behavioral Sciences (2nd edn). Hillsdale, NJ: Lawrence Erlbaum.
17.
CookJAGreyDBurkeJ, et al. (2004) Depressive symptoms and AIDS-related mortality among a multisite cohort of HIV-positive women. American Journal of Public Health94: 1133–1140.
18.
CuiipersPStratenAAnderssonG, et al. (2008) Psychotherapy for depression in adults: A meta-analysis of comparative outcome studies. Journal of Consulting and Clinical Psychology76: 909–922.
19.
DalessandroMContiCMGambiF, et al. (2007) Antidepressant therapy can improve adherence to antiretroviral regimens among HIV-infected and depressed patients. Journal of Clinical Psychopharmacology27: 58–61.
20.
DaviesEBMorrissRGlazebrookC (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 Research16: e130.
21.
DoANRosenbergESSullivanPS, 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 ONE9: e92842.
22.
DobkinRDInterianADurlandJL, et al. (2018) Personalized telemedicine for depression in Parkinson’s disease: A pilot trial. Journal of Geriatric Psychiatry and Neurology31: 171–176.
23.
EgedeLEAciernoRKnappRG, et al. (2015) Psychotherapy for depression in older veterans via telemedicine: A randomised, open-label, non-inferiority trial. The Lancet Psychiatry2: 693–701.
24.
FarinpourRMillerENSatzP, et al. (2003) Psychosocial risk factors of HIV morbidity and mortality: Findings from the Multicenter AIDS Cohort Study (MACS). Journal of Clinical and Experimental Neuropsychology25: 654–670.
25.
GidoraHBoryckiEMKushnirukAW (2019) Effects of telenursing triage and advice on healthcare costs and resource use. Studies in Health Technology and Informatics257: 133–139.
26.
GonzalezJSBatchelderAWPsarosC, et al. (2011) Depression and HIV/AIDS treatment nonadherence: A review and meta-analysis. Journal of Acquired Immune Deficiency Syndromes58: 181–187.
27.
HeckmanTGSomlaiAMPetersJ, et al. (1998) Barriers to care among persons living with HIV/AIDS in urban and rural areas. AIDS Care10: 365–375.
28.
HimelhochSMohrDMaxfieldJ, 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 & Medicine16: 156–165.
29.
HodderSLJustmanJHughesJP, et al. (2013) HIV acquisition among women from selected areas of the United States: A cohort study. Annals of Internal Medicine158: 10–18.
30.
JunkinsAAzueroAOttC, et al. (2019) Center for Epidemiological Studies-Depression Scale: Evaluation of a new cutoff score for women living with HIV. AIDS Patient Care and STDs33: 343–345.
31.
KempfMCHuangCHSavageR, et al. (2015) Technology-delivered mental health interventions for people living with HIV/AIDS (PLWHA): A review of recent advances. Current HIV/AIDS Reports12: 472–480.
32.
KempfMCMcLeodJBoehmeAK, 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 STDs24: 515–520.
33.
LeonACDavisLLKraemerHC (2011) The role and interpretation of pilot studies in clinical research. Journal of Psychiatric Research45: 626–629.
34.
LorentzMM (2008) Telenursing and home healthcare. the many facets of technology. Home Healthcare Nurse26: 237–243.
35.
MoneyhamLMcLeodJBoehmeA, et al. (2010) Perceived barriers to HIV care among HIV-infected women in the deep South. Journal of the Association of Nurses in AIDS Care21: 467–477.
36.
MugaveroMOstermannJWhettenK, et al. (2006) Barriers to antiretroviral adherence: The importance of depression, abuse, and other traumatic events. AIDS Patient Care and STDs20: 418–428.
37.
MurphyDAWilsonCMDurakoSJ, et al. (2001) Antiretroviral medication adherence among the REACH HIV-infected adolescent cohort in the USA. AIDS Care13: 27–40.
38.
NairUArmfieldNRChatfieldMD, et al. (2018) The effectiveness of telemedicine interventions to address maternal depression: A systematic review and meta-analysis. Journal of Telemedicine and Telecare24: 639–650.
39.
NanniMGCarusoRMitchellAJ, et al. (2015) Depression in HIV infected patients: A review. Current Psychiatry Reports17: 530.
40.
PatersonDLSwindellsSMohrJ, et al. (2000) Adherence to protease inhibitor therapy and outcomes in patients with HIV infection. Annals of Internal Medicine133: 21–30.
41.
PellowskiJA (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 Care24: 422–437.
42.
PenceBWMillerWCWhettenK, 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 Syndromes42: 298–306.
43.
RabkinJG (2008) HIV and depression: 2008 review and update. Current HIV/AIDS Reports5: 163–171.
44.
RadloffLS (1977) The CES-D Scale: A Self-Report Depression Scale for research in the general population. Applied Psychological Measurement1: 385–401.
45.
ReifSGeonnottiKLWhettenK (2006) HIV infection and AIDS in the deep South. American Journal of Public Health96: 970–973.
46.
RobertsKJMannT (2000) Barriers to antiretroviral medication adherence in HIV-infected women. AIDS Care12: 377–386.
47.
RobertsonKBayonCMolinaJM, et al. (2014) Screening for neurocognitive impairment, depression, and anxiety in HIV-infected patients in Western Europe and Canada. AIDS Care26: 1555–1561.
48.
RohlandBM (2001) Telepsychiatry in the heartland: If we build it, will they come?Community Mental Health Journal37: 449–459.
RushKLHowlettLMunroA, et al. (2018) Videoconference compared to telephone in healthcare delivery: A systematic review. International Journal of Medical Informatics118: 44–53.
51.
SafrenSABedoyaCAO’CleirighC, et al. (2016) Cognitive behavioural therapy for adherence and depression in patients with HIV: A three-arm randomised controlled trial. Lancet HIV3: e529–538.
52.
SafrenSAO’CleirighCTanJY, 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 Psychology28: 1–10.
53.
SafrenSAO’CleirighCMBullisJR, 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 Psychology80: 404–415.
54.
SafrenSAOttoMWorthJ (1999) Life steps: Applying cognitive behavioral therapy to HIV medication adherence. Cognitive and Behavioral Practice6: 332–341.
55.
SchumacherJEMcCullumsmithCMugaveroMJ, 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 Behavior17: 2781–2791.
56.
SherrLClucasCHardingR, et al. (2011) HIV and depression—A systematic review of interventions. Psychology, Health & Medicine16: 493–527.
57.
StringerKLAzueroAOttC, 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 Behavior23: 1306–1314.
58.
SwintonJJRobinsonWDBischoffRJ (2009) Telehealth and rural depression: Physician and patient perspectives. Families, Systems & Health: The Journal of Collaborative Family Healthcare27: 172–182.
59.
TurnerBJLaineCCoslerL, et al. (2003) Relationship of gender, depression, and health care delivery with antiretroviral adherence in HIV-infected drug users. Journal of General Internal Medicine18: 248–257.
60.
VandelanotteCDe BourdeaudhujiI (2003) Acceptability and feasibility of a computer-tailored physical activity intervention using stages of change: Project FAITH. Health Education Research18: 304–317.
61.
VyavaharkarMMoneyhamLMurdaughC, et al. (2012) Factors associated with quality of life among rural women with HIV disease. AIDS and Behavior16: 295–303.
62.
WampoldBEMinamiTBaskinTW, et al. (2002) A meta-(re)analysis of the effects of cognitive therapy versus “other therapies” for depression. Journal of Affective Disorders68: 159–165.
63.
XuTPujaraSSuttonS, et al. (2018) Telemedicine in the management of type 1 diabetes. Preventing Chronic Disease15: E13.
