Introduction
Methods
Search Strategy and Study Selection
Problems of Multiplicity
Data Extraction and Coding
Intervention types | Intervention techniques (in symptom-oriented interventions only) |
---|---|
Symptom-oriented intervention (e.g., cognitive and/or behavioral therapy, stress-management, interpersonal therapy) | Relaxation |
Supportive intervention (e.g., support, psycho-education) | CBT |
Meditation intervention (e.g., mindfulness, meditation, relaxation) | Motivational interviewing |
Stress-management |
Study Quality
Moderators
Data Analysis
Results
Study Characteristics
Authors and year of publication | Country and recruitment perioda
|
N after randomization and sample descriptionb
| Mean age (SD) | Female (%) | Intervention: name (N)c, type (T)d (techniques)e, provider (P)f, duration (D)g, setting (S)h
| Control group | Outcomes and measuresi
| Follow-up | Drop-out (%)j
| ITTk
|
---|---|---|---|---|---|---|---|---|---|---|
Balfour et al., 2006 [35] | Canada 2000–2004 |
N = 27, PLWH diagnosed with depression | NR | NR | N: Supportive Therapy for Adherence; T: Supportive intervention; P: Psychologist; D: 5 h; S: Individual | Standard care | Depression: CES-D | – | 0 | Yes |
Berger et al., 2008 [36] | Switzerland 2003–2004 |
N = 104, PLWH on ART | 43.96 | 14 | N: Cognitive behavioral stress management; T: Symptom-oriented intervention (CBT, relaxation, stress-management); P: Psychotherapist; D: 24 h; S: Group | Standard care | Depression: HADS | 6 and 12 months | 26 | Yes |
Anxiety: HADS | ||||||||||
Quality of life: MOS-HIV | ||||||||||
Boivin et al., 2013a [37] | Uganda 2008–2010 |
N = 71, mothers with HIV | 33.69 | 100 | N: Mediational intervention for sensitizing caregivers; T: Supportive intervention; P: Field trainer; D: 26 h; S: Individual | Active control group: information | Depression: HSCL-25 | – | 17 | NR |
Anxiety: HSCL-25 | ||||||||||
Boivin et al., 2013b [38] | Uganda 2008–2010 |
N = 109, mothers with HIV | NR | 100 | N: Mediational intervention for sensitizing caregivers; T: Supportive intervention; P: Field trainer; D: 26 h; S: Individual | Active control group: information | Depression: HSCL-25 | – | 0 | Yes |
Anxiety: HSCL-25 | ||||||||||
Bormann et al., 2006 [39] | USA 2003–2004 |
N = 93, PLWH for more than 6 months | 42.9 (6.84) | 81 | N: Spirtual mantram repetition; T: Meditation; P: Nurse; D: 10 h; S: Group and individual | Active control group: information and discussion | Depression: CES-D | 3 months | 20 | Yes |
Anxiety: STAI | ||||||||||
Quality of life: Q-LES-Q | ||||||||||
Well-being: PSS, FACIT-SpEx | ||||||||||
Brazier et al., 2006 [23] | Canada 2000 |
N = 62, PLWH | NR | NR | N: The art of living with HIV program; T: Meditation; P: NR; D: NR; S: Group | Standard care | Quality of life: MOS-HIV | – | 24 | NR |
Well-being: MHI, DSI | ||||||||||
Brown et al., 2011 [40] | USA 2009 |
N = 60, females with HIV | 44.7 (8.80) | 100 | N: Computerized stress management training; T: Symptom-oriented intervention (CBT, relaxation, motivational interviewing, stress-management); P: Computer; D: 2 h; S: Individual | Waiting list | Depression: CES-D, BSI | – | 2 | NR |
Anxiety: BSI, POMS | ||||||||||
Well-being: PSS, HIV-related life- stressor burden questionnaire | ||||||||||
Carrico et al., 2006 [41] | USA 1998–2004 |
N = 130, gay/bisexual men with HIV | 41.6 (8.60) | 0 | N: Cognitive behavioral stress management; T: Symptom-oriented intervention (CBT, relaxation, stress-management); P: Psychologist; D: 22.5 h; S: Group | Active control group: information | Depression: POMS | – | 25 | Yes |
Carrico et al., 2009 [42] | USA 2000–2002 |
N = 936, PLWH that had unprotected sex | 39.8 | 21 | N: Healthy living project: CBT; T: Symptom-oriented intervention (CBT); P: NR; D: 22.5 h; S: Individual | Waiting list | Depression: BDI | 7.5 and 12.5 months | 20 | Yes |
Anxiety: STAI | ||||||||||
Quality of life: SF-36 | ||||||||||
Well-being: PSS | ||||||||||
Chan et al., 2005 [43] | China NR |
N = 16, males with HIV | 38.15 (8.03) | 0 | N: Group CBT; T: Symptom-oriented intervention (CBT, relaxation, stress-management); P: Psychologist; D: 14 h; S: Group | Waiting list | Depression: CES-D | – | 19 | No |
Quality of life: SF-36 | ||||||||||
Chang et al., 2007 [44] | USA 2003–2004 |
N = 119, PLWH that suffer from HIV-related symptoms | 45.5 (7.5) | 15 | N: Relaxation during acupuncture treatment; T: Meditation; P: Tape; D: 10.5 h; S: Individual | Standard care | Quality of life: MOS-HIV, FAHI | – | 33 | NR |
Chhatre et al., 2013 [45] | USA 2011 |
N = 22, PLWH on ART | 49.9 (5.7) | 18 | N: Transcendental meditation; T: Meditation; P: Certified instructor; D: 28 h; S: Group | Active control group: information | Depression: CES-D | – | 9 | No |
Quality of life: SF-36, FAHI | ||||||||||
Well-being: PSS | ||||||||||
Côté & Pepler, 2002 [46] | Canada 1996–1998 |
N = 90, males with HIV | 40 | 0 | N1: Cognitive coping skills intervention; T1: Symptom-oriented intervention (CBT); N2: Expression of emotions intervention; T2: Supportive intervention; P: Nurse; D: 1.25 h; S: Individual | Waiting list | Well-being: PANAS | – | NR | No |
Duncan et al., 2012 [47] | USA 2006–2008 |
N = 76, PLWH with distress | 48.06 (7.93) | 16 | N: Mindfulness based stress reduction; T: Meditation; P: Mindfulness teacher; D: 30 h; S: Group & individual | Standard care | Depression: BDI | 3 months | 14 | Yes |
Well-being: PSS, PANAS | ||||||||||
Eller et al., 2013 [48] | South Africa, Puerto Rico, USA 2005–2007 |
N = 222, PLWH with depression | 43.15 (9.59) | 42 | N: HIV/AIDS symptom management manual; T: Supportive intervention; P: Self-help; D: NR; S: Individual | Active control group: information | Depression: depressive symptom intensity and frequency | 2 months | 18 | NR |
Erlen et al., 2001 [49] | USA 1998 |
N = 20, people with AIDS | 42.05 | 20 | N: Life review; T: Symptom-oriented intervention; P: Nurse; D: 6 h; S: Individual | Standard care | Depression: CES-D | 3 and 12 months | NR | NR |
Quality of life: Ferrans and Powers Quality of Life Index | ||||||||||
Fife et al., 2008 [50] | USA NR |
N = 80, PLWH | NR | 30 | N: A psychosocial education model; T: Symptom-oriented intervention (stress-management); P: NR; D: 8 h; S: Other (with partner) | Active control group: telephone support | Depression: PANAS | 3 months | 33 | No |
Anxiety: PANAS | ||||||||||
Well-being: PANAS | ||||||||||
Gayner et al., 2012 [51] | Canada 2004–2007 |
N = 117, males with HIV | 43.79 (7.08) | 0 | N: Mindfulness based stress reduction; T: Meditation; P: Social worker & psychologist; D: 30 h; S: Group | Standard care | Depression: HADS | 8 months | 12 | Yes |
Anxiety: HADS | ||||||||||
Well-being: PANAS | ||||||||||
Heckman & Carlson, 2007 [52] | USA 1999–2002 |
N = 299, PLWH | 43.10 | 30 | N1: Telephone coping improvement group; T1: Symptom-oriented intervention (CBT); N2: Telephone information support group; T2: Supportive intervention; P: Practitioner; D: 12 h; S: Group | Standard care | Depression: BDI | 4 and 8 months | 14 | Yes |
Quality of life: FAHI | ||||||||||
Well-being: SCL-90, HIV-related life stressor burden scale | ||||||||||
Heckman et al., 2011 [53] | USA 2004–2007 |
N = 295, PLWH with depressive symptoms, age > 49 years | 55.30 (4.80) | 33 | N1: Coping improvement group; T1: Symptom-oriented intervention (stress-management); N2: Interpersonal support group; T2: Supportive intervention; P: Social worker & psychologist; D: 18 h; S: Group | Active control group: telephone check-ups and individual therapy when needed | Depression: GDS | 4 and 8 months | 17 | Yes |
Heckman et al., 2013 [54] | USA 2008–2010 |
N = 361, PLWH with depressive symptoms, age > 49 years | 59.00 (5.10) | 39 | N1: Telephone coping effectiveness training; T1: Symptom-oriented intervention (CBT, stress-management); N2: Telephone supportive-expressive group; T2: Supportive intervention; P: Therapist; D: 18 h; S: Group | Standard care | Depression: GDS | 4 and 8 months | 8 | Yes |
Hersch et al., 2013 [55] | USA 2010–2011 |
N = 168, PLWH on ART | 46.34 (9.84) | 24 | N: Life steps intervention; T: Symptom-oriented intervention (CBT, relaxation, stress-management); P: Computer; D: NR; S: Individual | Waiting list | Well-being: HIV/AIDS stress scale, PANAS | 3 and 6 months | 9 | Yes |
Ironson et al., 2013 [56] | USA 2004–2009 |
N = 244, PLWH in mid-range of illness | 42.80 (8.80) | 39 | N: Augmented trauma writing; T: Symptom-oriented intervention; P: Self-help; D: 2 h; S: Individual | Active control group: daily event writing | Depression: HAM-D | 6 and 12 months | 12 | Yes |
Jensen et al., 2013 [57] | USA 2000–2004 |
N = 72, females with HIV | 31.27 (8.41) | 100 | N: Cognitive behavioral stress management; T: Symptom-oriented intervention (CBT, relaxation, stress-management); P: Psychologist; D: 22.5 h; S: Group | Active control group: psycho-education | Depression: BDI | 6 months | NR | Yes |
Well-being: FACIT-SpEx | ||||||||||
Kaaya et al., 2013 [58] | Tanzania 2001–2004 |
N = 331, pregnant women with HIV | 26.00 | 100 | N: Counselling; T: Supportive intervention; P: Social worker/nurse; D: NR; S: Group | Standard care | Depression: HSCL-25 | – | 43 | No |
Kalichman et al., 2005 [59] | USA 1999–2000 |
N = 125, PLWH that had sex with nonconcordant sex partners | NR | 30 | N: Healthy relationships intervention; T: Symptom-oriented intervention (CBT, stress-management); P: NR; D: 10 h; S: Group | Active control group: information and support | Depression: BDI | 3 and 6 months | 35 | No |
Anxiety: BSI | ||||||||||
Well-being: HIV-related stress | ||||||||||
Klein et al., 2013 [60] | USA 2011 |
N = 175, African American females with HIV | 40.70 (8.50) | 100 | N: Women involved in life learning from other women; T: Symptom-oriented intervention (relaxation, stress-management); P: Computer; D: 2 h; S: Individual | Active control group: information and discussion | Well-being: Willow Stress Scale | – | 4 | Yes |
Kraaij et al., 2010 [61] | The Nether-lands 2008 |
N = 73, PLWH | 49.48 (8.15) | 11 | N1: CBT self-help; T1: Symptom-oriented intervention (CBT, relaxation); N2: Computerized structured writing; T2: Symptom-oriented intervention; P: Self-help; D1: 16 h; D2: 2 h; S: Individual | Waiting list | Depression: HADS | – | 25 | No |
Lechner et al., 2003 [62] | USA NR |
N = 330, women with AIDS | 39.60 (7.14) | 100 | N: Cognitive behavioral stress management + expressive/supportive therapy; T: Symptom-oriented intervention (CBT, relaxation, stress-management); P: Psychologist; D: 20 h; S: Individual | Active control group: psycho-education | Quality of life: MOS-HIV | – | 18 | Yes |
Li et al., 2010 [63] | Thailand 2007 |
N = 507, PLWH | 37.40 (6.60) | 67 | N: Behavioral intervention; T: Symptom-oriented intervention (stress-management); P: Nurse/counsellor; D: 18 h; S: Group | Standard care | Quality of life: MOS-HIV | 6 months | 2 | NR |
Lovejoy, 2012 [64] | USA 2009–2010 |
N = 100, PLWH that had unprotected sex, age > 44 years | 53.80 (4.90) | 46 | N1: Motivational Interviewing (1 session); T1: Symptom-oriented intervention (motivational interviewing); N2: Motivational Interviewing (4 sessions); T2: Symptom-oriented intervention (motivational interviewing); P: Psychologist; D1: 0.81 h; D2: 2.72 h; S: Group | Active control group: encouraged to obtain information and support | Depression: DASS | 3 months | 8 | Yes |
Anxiety: DASS | ||||||||||
Well-being: DASS | ||||||||||
McCain et al., 2008 [65] | USA 2000–2004 |
N = 387, PLWH | 42.20 | 40 | N1: Cognitive behavioral relaxation; T1: Symptom-oriented intervention (CBT, relaxation, stress-management); N2: Tai Chi Training; T2: Meditation; N3: Spirtual growth; T3: Meditation; P: Investigator; D: 15 h; S: Group | Waiting list | Quality of life: FAHI | 6 months | NR | Yes |
Miles et al., 2003 [66] | USA 1997–2000 |
N = 109, African America females with HIV | 35.50 (8.49) | 100 | N: Maternal self-care symptom management; T: Supportive intervention; P: Nurse; D: NR; S: Individual | Standard care | Depression: CES-D, POMS | 5 months | 32 | Yes |
Anxiety: POMS, HIV worry scale | ||||||||||
Quality of life: MOS-HIV | ||||||||||
Miller et al., 2005 [67] | USA 1999–2000 |
N = 12, PLWH | 39.42 (9.75) | 25 | N: Supportive-affective group experience; T: Supportive intervention; P: Mediators; D: 18 h; S: Group | Active control group: sent self-help materials | Depression: BDI | – | 25 | No |
Anxiety: STAI state | ||||||||||
Well-being: SWS; DDS | ||||||||||
Mitrani et al., 2012 [68] | USA 2003–2007 |
N = 126, females with HIV and substance use diagnosis | 42.60 (7.50) | 100 | N: Structural Ecosystems Therapy; T: Symptom-oriented intervention (CBT); P: Social worker; D: 5.2 h; S: Other (family) | Active control group: information | Depression: BSI, SIGH-AD | 4 and 8 months | 8 | Yes |
Anxiety: BSI, SIGH-AD | ||||||||||
Well-being: PSS | ||||||||||
Murphy et al., 2002 [69] | USA 1999–2000 |
N = 52, PLWH with adherence problems | 39.00 (6.88) | 12 | N: CBT for adherence; T: Symptom-oriented intervention (CBT); P: NR; D: NR; S: Group & individual | Standard care | Depression: CES-D, RAND mental health inventory | 3 months | 37 | No |
Anxiety: health-related anxiety, RAND mental health inventory | ||||||||||
Murphy et al., 2011 [70] | USA 2007–2009 |
N = 80, mothers with HIV | 37.40 (6.80) | 100 | N: Teaching, Raising and Communicating with Kids program; T: Supportive intervention; P: Social worker; D: 3.25 h; S: Group | Standard care | Depression: RAND mental health inventory | 5 and 8 months | 14 | Yes |
Anxiety: RAND mental health inventory | ||||||||||
Quality of life: SF-36 | ||||||||||
O’Leary et al., 2005 [71] | USA 2000–2001 |
N = 811, males with HIV that had sex with male partners whose HIV status was seronegative or unknown | 41.00 (7.90) | 0 | N: Peer-led behavioral intervention; T: Supportive intervention; P: Peer; D: 18 h; S: Group | Active control group: information and discussion | Depression: BSI | 6 months | 15 | No |
Anxiety: BSI | ||||||||||
Olley, 2006 [72] | Nigeria NR |
N = 67, PLWH | 27.40 (8.10) | 56 | N: Psycho-education; T: Supportive intervention; P: NR; D: 4 h; S: Individual | Active control group: discussion and support | Depression: BDI | 1 month | 7 | NR |
Anxiety: CCEI | ||||||||||
Pacella et al., 2012 [73] | USA 2005–2008 |
N = 66, PLWH with PTSD and on ART | 46.37 (6.30) | 37 | N: Prolonged exposure; T: Symptom-oriented intervention (CBT); P: Psychologist; D: 17.5 h; S: Individual | Active control group: telephone check-ups | Depression: CES-D | 3 months | 29 | Yes |
Well-being: PTCI | ||||||||||
Peltzer et al., 2012 [74] | South Africa 2010 |
N = 152, PLWH with adherence problems | 36.90 (6.50) | 65 | N: Medication adherence intervention; T: Supportive intervention; P: Counsellor; D: 3 h; S: Group | Standard care | Depression: BDI | 3 months | 3 | NR |
Petersen et al., 2014 [75] | South Africa 2012–2013 |
N = 76, PLWH diagnosed with depression | 37.59 (10.36) | 74 | N: Group-based interpersonal psychotherapy; T: Symptom-oriented intervention (CBT); P: HIV specialist; D: 8 h; S: Group | Standard care | Depression: PHQ-9 | – | 55 | No |
Anxiety: HSCL-25 | ||||||||||
Ransom et al., 2008 [76] | USA 2006–2007 |
N = 79, PLWH with depression | 44.40 (8.60) | 16 | N: Telephone interpersonal psychotherapy; T: Symptom-oriented intervention; P: Psychologist; D: 5 h; S: Individual | Standard care | Depression: BDI | – | 16 | Yes |
Well-being: OQ | ||||||||||
Rao et al., 2009 [24] | USA 2006–2007 |
N = 79, PLWH | 42.00 (10.00) | 25 | N: Art therapy; T: Symptom-oriented intervention; P: Art therapist; D: 1 h; S: Individual | Active control group: videotape | Anxiety: STAI state | – | 4 | No |
Rotherham-Borus et al., 2012 [25] | USA 2005–2006 |
N = 339, mothers with HIV | 40.20 (8.20) | 100 | N: Family CBT; T: Symptom-oriented intervention (CBT); P: NR; D: 28 h; S: Other (group and family) | Waiting list | Well-being: BSI | 6 and 12 months | 8 | Yes |
Safren et al., 2009 [77] | USA 2002–2004 |
N = 45, PLWH with depression and on ART | NR | 16 | N: CBT for adherence and depression; T: Symptom-oriented intervention (CBT, relaxation, motivational interviewing); P: Psychologist; D: 8.68 h; S: Individual | Active control group: single session about adherence | Depression: BDI, HAM-D | 3 and 9 months | 7 | Yes |
Well-being: CGI | ||||||||||
Safren et al., 2012 [78] | USA 2005–2008 |
N = 89, PLWH with depression and substance use disorder | 46.85 (7.15) | 39 | N: CBT for adherence and depression; T: Symptom-oriented intervention (CBT, relaxation, motivational interviewing); P: Psychologist; D: 6.64 h; S: Individual | Active control group: single session about adherence | Depression: BDI, MADRS | 3 and 9 months | 9 | Yes |
Well-being: CGI | ||||||||||
Sarna et al., 2008 [22] | Kenya 2003–2004 |
N = 234, PLWH that started with ART | 37.15 (7.90) | 64 | N: Adherence intervention; T: Supportive intervention; P: Nurse; D: NR; S: Individual | Active control group: counselling | Depression: BDI | 5.5 and 11 months | 15 | NR |
SeyedAlinaghi et al., 2012 [79] | Iran 2008–2010 |
N = 245, PLWH | 35.10 (6.50) | 31 | N: Mindfulness based stress reduction; T: Meditation; P: Psychologist; D: 25.75 h; S: Group | Active control group: information and support | Depression: SCL-90 | 3, 6, 9 and 12 months | 29 | No |
Anxiety: SCL-90 | ||||||||||
Shuter et al., 2014 [80] | USA 2012–2013 |
N = 138, PLWH interested in quitting smoking | 45.62 (9.91) | 43 | N: Positively smoke free on the web; T: Symptom-oriented intervention; P: Computer; D: 2 h; S: Individual | Active control group: advice and brochure | Depression: CES-D | 2.5 months | 9 | Yes |
Anxiety: GAD-7 | ||||||||||
Well-being: PSS | ||||||||||
USA 1997–1999 |
N = 267, PLWH that lost a loved one to AIDS | 40.10 (7.02) | 35 | N: CBT; T: Symptom-oriented intervention (CBT, stress-management); P: Therapist; D: 18 h; S: Group | Standard care | Depression: SCL-90, HAM-D | 4, 8 and 12 months | 12 | No | |
Anxiety: SCL-90, HAM-A | ||||||||||
Quality of life: FAHI | ||||||||||
Simoni et al., 2007 [85] | USA 2000–2002 |
N = 136, PLWH on ART | 42.60 (8.90) | 45 | N: Peer support; T: Supportive intervention; P: Peer; D: 12 h; S: Group & individual | Standard care | Depression: CES-D | 3 months | 23 | No |
Simoni et al., 2013 [86] | USA/Mexico 2009–2011 |
N = 40, PLWH with depressive symptoms and adherence problems | 46.00 (10.60) | 28 | N: CBT for adherence and depression and electronic pillbox; T: Symptom-oriented intervention (CBT, relaxation, motivational interviewing); P: Psychologist; D: 9 h; S: Individual | Standard care | Depression: BDI, MADRS | 3 months | 15 | Yes |
Stein et al., 2007 [26] | USA 2001–2004 |
N = 177, PLWH with depressive symptoms | 40.30 (7.40) | 44 | N: Telephone family intervention; T: Supportive intervention; P: Social worker, psychologist, nurse; D: 2.6 h; S: Other (with partner) | Waiting list | Depression: BDI | – | 10 | No |
Szapocznik et al., 2004 [87] | USA 1996–1999 |
N = 209, African American mothers | 36.00 (8.00) | 100 | N1: Structural Ecosystems Therapy; T1: Symptom-oriented intervention (CBT); N2: Attention condition; T2: Supportive intervention; P: Counsellor, social worker, therapist; D1: 12.45 h; D2: 5.74 h; S1: Other (family); S2: Individual | Standard care | Depression: BSI | 9 months | 8 | Yes |
Anxiety: BSI | ||||||||||
Van Tam et al., 2012 [88] | Vietnam 2008–2009 |
N = 275, PLWH that started with ART | NR | 32 | N: Peer support for adherence; T: Supportive intervention; P: Peer; D: NR; S: Individual | Active control group: adherence counselling | Quality of life: WHOQOL-HIVBREF | – | 17 | No |
Vidrine et al., 2006 [89] | USA 2004 |
N = 95, PLWH interested in quitting smoking | 42.80 (8.10) | 22 | N: Telephone counselling for smoking cessation; T: Symptom-oriented intervention (CBT); P: Counsellor; D: NR; S: Individual | Active control group: advice and self-help | Depression: CES-D | – | 16 | NR |
Anxiety: STAI state | ||||||||||
Webel, 2010 [90] | USA 2008 |
N = 89, females with HIV | 47.00 (8.16) | 100 | N: HIV symptom management; T: Symptom-oriented intervention (CBT, relaxation); P: Peer; D: 14 h; S: Group | Active control group: self-help manual | Quality of life: HIV/AIDS targeted quality of life instrument | 1.75 months | 48 | Yes |
Weber et al., 2004 [27] | Switzerland NR |
N = 60, PLWH on ART | NR | 17 | N: CBT; T: Symptom-oriented intervention (CBT); P: Psychotherapist; D: NR; S: Individual | Standard care | Well-being: SCL-90 | – | 12 | NR |
Williams et al., 2005 [91] | USA 2001–2003 |
N = 58, people with advanced AIDS | 45.09 (2.22) | 21 | N1: Meditation; T1: Meditation; N2: Meditation and massage; T2: Meditation; P1: Meditation teacher; P2: Meditation teacher and massage therapist; D1: 8.5 h; D2: 18.5 h; S: Group & individual | C1: active control group: provision of mental health services; C2: active control group: massage | Quality of life: MVQOLI | 17 months | 29 | Yes |
Williams et al., 2008 [92] | USA 2003–2006 |
N = 164, males with HIV and experience of childhood sexual abuse | 43.50 (8.00) | 0 | N: Sexual Health Intervention for Men; T: Symptom-oriented intervention (CBT); P: Trained male facilitator; D: 12 h; S: Group | Active control group: information and discussion | Depression: CES-D | 3 and 6 months | 16 | No |
Williams et al., 2013 [93] | USA 2007–2011 |
N = 117, African American males with HIV that had unprotected sex | 46.60 (8.30) | 0 | N: Enhanced sexual health intervention for men; T: Symptom-oriented intervention (CBT, stress-management); P: Trained male facilitator; D: 12 h; S: Group | Active control group: information | Depression: BDI | 6 months | 27 | No |
Intervention Characteristics
Quality of the Included Studies
Study | Sequence generation | Allocation concealment | Incomplete outcome data | Selective outcome reporting | Availability of treatment manual | Use of training for therapy providers | Treatment integrity was checked | Quality classificationa
|
---|---|---|---|---|---|---|---|---|
Balfour et al. [35] | + | + | + | ? | + | + | ? | High |
Berger et al. [36] | + | + | + | + | + | + | ? | High |
Boivin et al. [37] | ? | ? | ? | ? | ? | + | + | Low |
Boivin et al. [38] | ? | ? | + | ? | ? | + | + | Medium |
Bormann et al. [39] | + | ? | + | ? | + | ? | + | Medium |
Brazier et al. [23] | + | ? | – | ? | ? | ? | ? | Low |
Brown et al. [40] | + | ? | + | ? | NA | NA | NA | Medium |
Carrico et al. [41] | + | ? | + | ? | + | ? | + | Medium |
Carrico et al. [42] | + | ? | + | ? | + | ? | + | Medium |
Chan et al. [43] | ? | ? | – | ? | + | ? | ? | Low |
Chang et al. [44] | + | + | + | ? | NA | NA | NA | High |
Chhatre et al. [45] | ? | ? | – | ? | ? | + | ? | Low |
Côté and Pepler [46] | ? | ? | – | ? | + | ? | + | Low |
Duncan et al. [47] | + | ? | ? | ? | ? | + | ? | Low |
Eller et al. [48] | ? | ? | ? | ? | NA | NA | NA | Low |
Erlen et al. [49] | ? | ? | ? | ? | ? | + | + | Low |
Fife et al. [50] | ? | ? | – | ? | + | ? | + | Low |
Gayner et al. [51] | + | + | + | ? | + | ? | ? | Medium |
Heckman and Carlson [52] | ? | ? | + | ? | + | ? | + | Medium |
Heckman et al. [53] | + | ? | + | ? | + | ? | + | Medium |
Heckman et al. [54] | + | ? | + | ? | + | – | + | Medium |
Hersch et al. [55] | ? | ? | + | ? | NA | NA | NA | Low |
Ironson et al. [56] | ? | ? | + | ? | NA | NA | NA | Low |
Jensen et al. [57] | ? | ? | + | ? | + | + | + | Medium |
Kaaya et al. [58] | + | + | – | ? | ? | + | ? | Medium |
Kalichman et al. [59] | + | + | – | ? | + | ? | + | Medium |
Klein et al. [60] | + | + | ? | ? | NA | NA | NA | Medium |
Kraaij et al. [61] | + | ? | – | ? | NA | NA | NA | Low |
Lechner et al. [62] | ? | ? | – | ? | + | + | + | Medium |
Li et al. [63] | ? | ? | ? | ? | + | + | ? | Low |
Lovejoy [64] | + | + | + | ? | + | + | + | High |
McCain et al. [65] | + | + | + | ? | + | + | ? | High |
Miles et al. [66] | + | ? | + | ? | ? | + | + | Medium |
Miller et al. [67] | ? | ? | – | ? | ? | + | ? | Low |
Mitrani et al. [68] | ? | ? | + | ? | + | + | + | Medium |
Murphy et al. [69] | + | ? | – | ? | + | ? | ? | Low |
Murphy et al. [70] | ? | ? | + | ? | + | ? | ? | Low |
O’Leary et al. [71] | + | ? | – | ? | + | + | ? | Medium |
Olley [72] | ? | ? | ? | ? | + | ? | ? | Low |
Pacella et al. [73] | ? | ? | + | ? | + | + | + | Medium |
Peltzer et al. [74] | + | ? | ? | ? | + | ? | ? | Low |
Petersen et al. [75] | + | ? | – | ? | + | + | + | Medium |
Ransom et al. [76] | ? | ? | + | ? | + | + | + | Medium |
Rao et al. [24] | ? | ? | + | ? | ? | ? | ? | Low |
Rotherham-Borus et al. [25] | ? | ? | + | + | + | + | + | High |
Safren et al. [77] | ? | ? | + | ? | + | ? | + | Medium |
Safren et al. [78] | ? | ? | + | ? | + | + | + | Medium |
Sarna et al. [22] | + | + | ? | ? | ? | + | + | Medium |
SeyedAlinaghi et al. [79] | + | ? | – | + | + | + | ? | Medium |
Shuter et al. [80] | + | ? | + | + | NA | NA | NA | High |
? | ? | – | ? | + | + | + | Medium | |
Simoni et al. [85] | + | + | – | ? | ? | + | + | Medium |
Simoni et al. [86] | + | + | + | ? | + | + | + | High |
Stein et al. [26] | ? | ? | – | ? | + | + | + | Medium |
Szapocznik et al. [87] | + | ? | + | ? | + | + | + | High |
Van Tam et al. [88] | ? | ? | – | ? | ? | + | + | Low |
Vidrine et al. [89] | + | ? | ? | ? | ? | + | ? | Low |
Webel [90] | ? | ? | + | ? | ? | + | ? | Low |
Weber et al. [27] | + | + | ? | ? | + | + | + | High |
Williams et al. [91] | + | ? | + | ? | ? | + | ? | Medium |
Williams et al. [92] | ? | ? | – | ? | ? | + | ? | Low |
Williams et al. [93] | ? | ? | – | ? | ? | + | ? | Low |
Intervention Effectiveness
Analysis | Subgroup |
k
a
| Hedges’ ĝ
| 95% CI |
Q
b
|
I
2 (%)c
|
---|---|---|---|---|---|---|
Overall effect | 62 | 0.19d
| 0.13, 0.25 | 99.35d
| 39 | |
Outcome | Depression | 47 | 0.21d
| 0.13, 0.29 | 87.32d
| 47 |
Anxiety | 22 | 0.09 | −0.01, 0.19 | 31.29 | 33 | |
Quality of life | 19 | 0.13d
| 0.04, 0.21 | 21.07 | 15 | |
Psychological well-being | 25 | 0.20d
| 0.09, 0.31 | 44.63d
| 46 | |
Intervention type | Symptom-oriented intervention | 39 | 0.19d
| 0.11, 0.28 | 69.71d
| 46 |
Supportive intervention | 20 | 0.21d
| 0.09, 0.33 | 43.58d
| 56 | |
Meditation intervention | 9 | 0.20d
| 0.06, 0.35 | 2.00 | 0 | |
Time point | Posttest 0–3 months | 59 | 0.18d
| 0.12, 0.25 | 85.79e
| 32 |
Posttest 3–6 months | 19 | 0.13d
| 0.05, 0.22 | 28.31 | 36 | |
Posttest 6–9 months | 12 | 0.18d
| 0.05, 0.31 | 22.97e
| 52 | |
Posttest >9 months | 9 | 0.08 | −0.05, 0.21 | 13.79 | 42 |
Intervention Effectiveness: Analysis on Last Time Point
Publication Bias
Moderator Analysis on the Outcome Depression
Moderator | Subgroup |
k
a
| Hedges’ ĝ
| 95% CI |
Q for differenceb
|
---|---|---|---|---|---|
Control group | Active control group | 24 | 0.22c
| 0.11, 0.33 | 6.74d
|
Standard care | 18 | 0.25c
| 0.14, 0.36 | ||
Waiting list | 5 | −0.04 | −0.24, 0.16 | ||
Location | Africa/Asia | 8 | 0.19c
| 0.05, 0.33 | 0.01 |
North America/Europe | 38 | 0.19c
| 0.10, 0.27 | ||
Othere
| 1 | ||||
First year recruitment | 1996–2001 | 16 | 0.13d
| 0.02, 0.24 | 4.37 |
2002–2006 | 15 | 0.32c
| 0.16, 0.47 | ||
2007–2012 | 13 | 0.13 | −0.01, 0.28 | ||
Missing | 3 | ||||
% Attrition | 0–10% | 14 | 0.18d
| 0.01, 0.36 | 1.14 |
10–20% | 17 | 0.20c
| 0.08, 0.32 | ||
>20% | 14 | 0.28c
| 0.15, 0.41 | ||
Missing | 2 | 0.03 | |||
% Females | 0–20% | 14 | 0.27c
| 0.15, 0.40 | 4.54 |
20–80% | 22 | 0.21c
| 0.09, 0.33 | ||
80–100% | 10 | 0.08 | −0.06, 0.21 | ||
Missing | 1 | ||||
Mean age | <42.40 years | 19 | 0.14c
| 0.04, 0.24 | 0.74 |
≥42.40 years | 22 | 0.21c
| 0.09, 0.32 | ||
Missing | 6 | ||||
% MSMf
| 0% | 10 | 0.10 | −0.05, 0.24 | 0.50 |
>0% | 10 | 0.17d
| 0.02, 0.31 | ||
Missing | 27 | ||||
% Participants with AIDS | <40% | 5 | 0.54c
| 0.38, 0.71 | 7.24c
|
≥40% | 5 | 0.19 | −0.01, 0.38 | ||
Missing | 37 | ||||
Mean duration HIV | <10.02 years | 10 | 0.16 | −0.05, 0.38 | 0.21 |
≥10.02 years | 13 | 0.22c
| 0.07, 0.38 | ||
Missing | 24 | ||||
% on ARTg
| <87% | 10 | 0.34c
| 0.15, 0.52 | 0.00 |
≥87% | 12 | 0.34c
| 0.18, 0.49 | ||
Missing | 25 | ||||
Screening on depression | No | 37 | 0.12c
| 0.05, 0.18 | 9.13c
|
Yes | 10 | 0.46c
| 0.25, 0.68 | ||
Mental health primary outcome | No | 6 | 0.17 | −0.02, 0.36 | 0.19 |
Yes | 41 | 0.22c
| 0.13, 0.30 | ||
Provider intervention | Psychologist | 13 | 0.42c
| 0.28, 0.56 | 12.92d
|
Counsellor | 21 | 0.15c
| 0.05, 0.25 | ||
Peer | 2 | 0.10 | −0.04, 0.25 | ||
None | 5 | 0.18 | −0.19, 0.54 | ||
Other (practitioner) | 1 | 0.06 | −0.22, 0.33 | ||
Missing | 5 | ||||
Format intervention | Group | 19 | 0.23c
| 0.14, 0.33 | 4.58 |
Individual | 20 | 0.25c
| 0.10, 0.40 | ||
Combination | 4 | 0.09 | −0.16, 0.33 | ||
Other | 4 | −0.01 | −0.26, 0.23 | ||
Analysis | ITTh
| 24 | 0.22c
| 0.11, 0.34 | 1.32 |
No ITTh
| 15 | 0.13d
| 0.02, 0.24 | ||
Missing | 8 | ||||
Study quality | Low | 17 | 0.23c
| 0.08, 0.38 | 0.53 |
Medium | 24 | 0.19c
| 0.09, 0.29 | ||
High | 6 | 0.28d
| 0.001, 0.57 |
Moderator Analysis: Effect of Intervention Characteristics on the Outcome Depression
Moderator | Subgroup |
m
a
| Hedges’ ĝ
| 95% CI |
Q for differenceb
|
---|---|---|---|---|---|
Relaxation techniquec
| No | 22 | 0.18d
| 0.06, 0.29 | 2.75 |
Yes | 9 | 0.38d
| 0.17, 0.59 | ||
Cognitive behavioral techniquec
| No | 9 | 0.15 | −0.07, 0.38 | 0.53 |
Yes | 22 | 0.25d
| 0.13, 0.37 | ||
Motivational interviewing techniquec
| No | 25 | 0.23d
| 0.12, 0.34 | 0.07 |
Yes | 6 | 0.18 | −0.16, 0.52 | ||
Stress-management techniquec
| No | 20 | 0.19d
| 0.06, 0.31 | 1.04 |
Yes | 11 | 0.29d
| 0.13, 0.45 | ||
Mental health primary focus intervention | No | 22 | 0.14d
| 0.06, 0.22 | 4.02e
|
Yes | 31 | 0.29d
| 0.02, 0.41 | ||
Theory-driven intervention | No | 19 | 0.22d
| 0.09, 0.36 | 0.01 |
Yes | 34 | 0.21d
| 0.12, 0.31 | ||
Treatment duration | 1–5 h | 13 | 0.06 | −0.09, 0.20 | 10.76e
|
5–12 h | 14 | 0.12 | −0.01, 0.25 | ||
12–18 h | 11 | 0.38d
| 0.23, 0.53 | ||
18–30 h | 9 | 0.17 | −0.003, 0.33 | ||
Missing | 6 |