Internet-Based Intervention Can Reduce Depression in People Living With HIV
A guided internet-based intervention may effectively treat depressive symptoms in people living with HIV.
A guided internet-based intervention can effectively reduce depressive symptoms for people living with HIV, according to results published in Lancet HIV.
The study included participants from 23 HIV treatment centers in The Netherlands who were age ≥18 years, had been diagnosed with HIV ≥6 months before the study, and had mild to moderate depressive symptoms (Patient Health Questionnaire-9 [PHQ-9] score >4 and <20). Additionally, participants were required to have internet access and an email address.
Participants were randomly assigned 1:1 to an internet-based intervention or an attention-only waiting-list control condition. The study's primary outcome was depressive symptoms assessed with the PHQ-9 and the Center for Epidemiologic Studies Depression Scale (CES-D) at baseline, 8 weeks after baseline, and 3 months after completion of the intervention or the control condition.
The study included a total of 188 participants, with 97 in the intervention group and 91 in the control group.
In the intervention group, the mean baseline PHQ-9 score was 11.74 compared with 11.11 for the control group. At 8 weeks, the mean PHQ-9 score was 6.73 in the intervention group compared with 8.60 in the control group. At 3 months postintervention, the mean score was 6.62 in the intervention group compared with 8.06 in the control group.
In the intervention group, the mean baseline CES-D score was 24.91 compared with 22.94 for the control group. At 8 weeks, the mean CES-D score was 13.94 in the intervention group compared with 19.09 in the control group. At 3 months postintervention, the mean score was 15.71 in the intervention group compared with 18.43 in the control group.
These results represent a significantly larger reduction in depressive symptoms as measured by either scale in the intervention group compared with the control group at both 8 weeks after baseline and 3 months-postintervention (d=–0.56 [95% CI –0.85 to –0.27] for PHQ-9 and –0.72 [–1.02 to –0.42] for CES-D at 8 weeks after baseline; –0.46 [–0.75 to –0.17] for PHQ-9 and –0.47 [–0.76 to –0.18] for CES-D at 3 months after intervention).
“For future research, it is important to investigate moderators and mediators of treatment effect to identify the subgroups for whom this intervention is the most optimal and the mechanisms that make this intervention effective,” the researchers wrote.
van Luenen S, Garnefski N, Spinhoven P, Kraaij V. Guided internet-based intervention for people with HIV and depressive symptoms: a randomised controlled trial in the Netherlands. Lancet HIV. 2018;5:e488-e497.