Cognitive Behavior Therapy helps prevent spread of HIV

The National Institute of Mental Health (NIMH) recently launched a Healthy Living Project to promote healthful behaviors among those who have HIV. The Healthy Living Project had two phases: 1) to qualitatively investigate and understand the living contexts of those with HIV and 2) to offer an intervention – Cognitive Behavior Therapy (CBT).

Through their randomized controlled study of a CBT intervention, recently published in the Journal of Acquired Immune Deficiency Syndromes, 3818 people with HIV were screened from across 4 cities (Los Angeles, Milwaukee, New York and San Francisco). Of those screened, 936 were determined to show risk of transmission, based on engaging in unprotected sex acts with those who were of non-HIV or unknown status.

The 936 participants were randomly assigned to either a CBT intervention group (N=467) or a control group (N=469) that did not receive any intervention. The CBT group received fifteen 90-minute sessions that focused on problem-solving and goal-setting, and addressed stress, coping, sexual risk behaviors and other HIV-specific health behaviors. CBT was delivered by facilitators who had been centrally trained, rated by their supervisors, and audiotaped throughout the study to ensure ongoing competency.

Participants had follow-up interviews every five months for two years following the intervention. Transmission risk was determined based on the number of self-reported unprotected sexual risk acts with a person of non-HIV or unknown status. There was greatest statistically significant difference at the 20-month follow up: a 36% reduction in the CBT intervention group as compared to the control group.

Researchers concluded that, “Cognitive behavioral intervention programs can effectively reduce the potential of HIV transmission to others among PLH [People Living with HIV] who report significant transmission risk behavior.”

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