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Cognitive—behavioural stress management with HIV-positive homosexual men: mechanisms of sustained reductions in depressive symptoms

Department of Psychology, PO Box 249229, University of Miami, Coral Gables, FL 33146, USA

Michael H. Antoni

Department of Psychology, PO Box 249229, University of Miami, Coral Gables, FL 33146, USA, Mantoni{at}miami.edu, Department of Psychiatry, PO Box 249229, University of Miami, Coral Gables, FL 33146, USA

Kathryn E. Weaver

Department of Psychology, PO Box 249229, University of Miami, Coral Gables, FL 33146, USA

Suzanne C. Lechner

Department of Psychiatry, PO Box 249229, University of Miami, Coral Gables, FL 33146, USA

Neil Schneiderman

Department of Psychology, PO Box 249229, University of Miami, Coral Gables, FL 33146, USA, Department of Psychiatry, PO Box 249229, University of Miami, Coral Gables, FL 33146, USA, Department of Medicine, Department of Psychiatry, PO Box 249229, University of Miami, Coral Gables, FL 33146, USA

Background: We examined the sustained efficacy of a group-based cognitive—behavioural stress management (CBSM) intervention in comparison to a modified wait-list control condition on measures of mood, coping and social support in mildly symptomatic HIV-positive homosexual and bisexual men. Participants were recruited largely during the era prior to highly active antiretroviral therapy (HAART; 1992—1997).

Methods: Men were randomized to either a 10-week, group-based CBSM intervention (n=83) or a psycho-educational seminar group (n=46). All participants completed a battery of psychosocial questionnaires administered by a research assistant at baseline, immediately following the 10-week CBSM intervention period, and at a 6-month follow-up.

Results: Men in the CBSM group maintained previously observed effects on depressive symptoms and perceived social support. These sustained effects of CBSM on depressive symptoms were mediated by 10-week increases in cognitive coping (i.e. positive reframing).

Discussion: CBSM appears to be a potentially efficacious treatment that reduces and maintains lower levels of depressive symptoms and enhances social support in HIV-positive homosexual and bisexual men. In particular, changes in positive reframing during the 10-week intervention period remain a crucial factor contributing to sustained reductions in depressive symptoms.

Key Words: AIDS • Coping • Depression • HIV • Intervention • Social support

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