Mindfulness-Based Stress Reduction for HIV Treatment Side Effects: A Randomized, Wait-List Controlled Trial

Duncan, Larissa G.; Moskowitz, Judith Tedlie; Neilands, Torsten B.; Dilworth, Samantha E.; Hecht, Frederick M.; Johnson, Mallory O.

doi:10.1016/j.jpainsymman.2011.04.007

« Previous Next »Journal of Pain and Symptom Management
Volume 43, Issue 2 , Pages 161-171, February 2012

Mindfulness-Based Stress Reduction for HIV Treatment Side Effects: A Randomized, Wait-List Controlled Trial

Portions of this study were presented by the senior author (M.O.J.) at the New Developments in the Psychology of Illness meeting held in the Yasawa Islands, Fiji in 2009.

Larissa G. Duncan, PhD
- Osher Center for Integrative Medicine, University of California at San Francisco School of Medicine, San Francisco, California, USA
Judith Tedlie Moskowitz, PhD, MPH
- Osher Center for Integrative Medicine, University of California at San Francisco School of Medicine, San Francisco, California, USA
Torsten B. Neilands, PhD
- Center for AIDS Prevention Studies, University of California at San Francisco School of Medicine, San Francisco, California, USA
Samantha E. Dilworth, MS
- Center for AIDS Prevention Studies, University of California at San Francisco School of Medicine, San Francisco, California, USA
Frederick M. Hecht, MD
- Osher Center for Integrative Medicine, University of California at San Francisco School of Medicine, San Francisco, California, USA
Mallory O. Johnson, PhD
- Center for AIDS Prevention Studies, University of California at San Francisco School of Medicine, San Francisco, California, USA
- Address correspondence to: Mallory O. Johnson, PhD, 50 Beale Street, Suite 1300, San Francisco, CA 94105, USA.

Accepted 12 April 2011. published online 19 September 2011.

Abstract

Context

Advances in antiretroviral therapy (ART) for HIV offer life-extending benefit; however, the side effects associated with ART use negatively impact quality of life and medication adherence among people living with HIV.

Objectives

This study tested the efficacy of Mindfulness-Based Stress Reduction (MBSR) for reducing ART symptoms and bother/distress related to ART side effects. Secondary aims were to test the impact of MBSR on medication adherence and psychological functioning.

Methods

Seventy-six people living with HIV who were actively taking ART and reported distress from ART-related side effects were randomly assigned to an MBSR program or a wait-list control (WLC) standard care condition. We measured side effects, ART adherence, perceived stress, depression, positive and negative affect, and mindfulness at three time points: baseline, three-month follow-up, and six-month follow-up. Side effects and related distress were assessed separately from other symptoms.

Results

Compared with a WLC, participants in the MBSR condition experienced a reduction in the frequency of symptoms attributable to ARTs at three months post-intervention (mean difference=0.33; 95% confidence interval [CI]=0.01, 0.66; t(132)=2.04, P=0.044) and six months post-intervention (mean difference=0.38; 95% CI=0.05, 0.71; t(132)=2.27, P=0.025). MBSR participants also experienced a reduction in distress associated with those symptoms at three months post-intervention (mean difference=0.47; 95% CI=0.003, 0.94; t(132)=1.99, P=0.048) compared with the WLC condition.