A Preliminary RCT of CBT-AD for Adherence and Depression among HIV-Positive Latinos on the U.S. –Mexico Border: The Nuevo Día Study

Authors

Jane Simoni, University of Washington
John S. Wiebe, University of Texas at El PasoFollow
John A. Sauceda, University of Texas at El PasoFollow
David Huh, University of Washington
Giselle Sanchez, University of South Florida
Virginia Longoria, New Mexico State University
Andres Bedoya, Harvard Medical School
Steven Safren, Harvard Medical School

Publication Date

2013

Document Type

Article

Comments

Simoni, J.M., Wiebe, J.S., Sauceda, J.A. et al. AIDS Behav (2013) 17: 2816. https://doi.org/10.1007/s10461-013-0538-5

Abstract

We conducted a preliminary RCT among 40 HIV-positive Latinos of Mexican descent on the U.S.-Mexico border who indicated imperfect adherence and depressive symptomatology. Participants were randomly assigned to culturally adapted cognitive-behavioral therapy for adherence and depression with an alarmed pillbox or usual care. Outcomes were depressive symptoms (self-report and blind clinician ratings), adherence (self-report and electronic pillbox), and biological markers. The intervention, delivered in English and Spanish, proved feasible and acceptable. Generalized estimating equations in intent-to-treat analyses showed some effects of “moderate” to “large” size, with maintenance over time. For example, intervention (vs. control) participants demonstrated at post-intervention a greater drop in BDI scores (OR = −3.64, p = 0.05) and greater adherence according to the electronic pillbox (OR = 3.78, p = 0.03). Biological markers indicated some relative improvement for CD4 count but not VL. The promising results suggest a larger trial to determine efficacy is warranted.