MBSR and Early Stage HIV
Currently there are no interventions designed specifically for individuals with early stage HIV infection who are not yet on antiretrovial therapy (ART). Interventions that slow the advance of HIV infection and delay the introduction of ART could make a very important contribution to HIV management in both the developed and developing world. There is evidence that stress and depression are associated with more rapid loss of CD4 cells in HIV infection.
We therefore plan a 330 person randomized, controlled clinical trial comparing a meditation based approach to stress reduction to education in self-management of HIV for people with early stage HIV disease.
Subjects will be followed for 1 year, with evaluations at baseline, 3 months, 6 months, and 12 months. At the end of 12 months the education group will be offered MBSR.
The primary aims of the study are to compare the MBSR group to the education group on declines in CD4 T-lymphocyte cell counts, HIV RNA levels, health related quality of life, and depression. We also aim to test the extent to which the participation in the intervention groups reduces other outcomes that have been associated with stress and depression such as frequency of upper respiratory tract infections.
Participants in the trial will form the subject pool for detailed studies of stress, neuroendocrine function, and immune function in Project 2 and Project 3 of this proposal. The results of the study will address the key question of whether a meditation-based intervention or education is able to alter the accelerated HIV disease progression associated with stress and depression. It will also extend our understanding of the effects of MBSR and education on outcomes such as stress, mood, health related quality of life, and resistance to upper respiratory tract infections, issues that are applicable to a broad range of populations.
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