Effectiveness of mindfulness-based stress reduction and mindfulness-based cognitive therapies on people living with HIV: A systematic review and meta-analysis

Abstract

Objective: To assess the effects of mindfulness-based therapies (MBTs) on the outcomes of people living with HIV. Methods: During 2014, we searched the PubMed/MEDLINE, Embase, Web of Science, Cochrane Library, and CBM databases to identify randomized and non-randomized controlled studies which compared participants receiving mindfulness-based therapies (MBTs), including mindfulness-based stress reduction (MBSR) and mindfulness-based cognitive therapy (MBCT), with participants in control groups. The psychological, biochemical, clinical, and behavioral outcomes of the study participants were analyzed. Two separate reviewers independently performed the study selection, data extraction, and quality assessment tasks, and a meta-analysis of selected studies was performed using RevMan software. Results: Seven articles describing results obtained with a total of 620 HIV-infected individuals enrolled in six randomized trials and one quasi-experimental trial were included in the final meta-analysis. The overall methodological quality of the studies was moderate, as most study criteria were unclear and subject to a high risk of bias. Patients receiving MBT experienced significantly decreased feelings of stress after 8 weeks (p = 0.03) of MBT, and decreased feelings of depression after both 8 weeks (p = 0.04) and 6 months (p = 0.02). Additionally, some patients receiving MBSR training or MBCT showed improved CD4+ counts at 8 weeks and 6 months, respectively. Conclusion: While MBT produced psychological benefits in HIV infected patients, any improvements in CD4+ counts were not robust. Additional studies with longer term follow-up periods and larger sample sizes are required to ascertain the effectiveness of such interventions.

Keywords

• HIV
• MBCT
• MBSR
• Meta-analysis
• Mindfulness
• Systematic review