Comparison of the Effectiveness of Mindfulness-based Cognitive Therapy and Silva-based Relaxation Therapy on Psychological Capital, Social Anxiety, and CD4+ Count in People Living with HIV in Iran.

Abstract

Background/ Objective: Due to the impact of human immunodeficiency virus (HIV) infection on personal and social life, people living with HIV (PLWH) are faced with several challenges and issues. Therefore, PLWH requires psychological interventions. The study aims were to create a suitable platform for psychological structures that empower them to address their issues effectively. In this regard, we evaluated the effect of Mindfulness-based Cognitive Therapy (MBCT) and Silva-based Relaxation Therapy (SBRT) on Psychological Capital (PsyCap), Social Anxiety (SA), and CD4 count in PLWH.

Methods: This study employed an intervention-based semi-experimental design. The population consisted of 90 individuals infected with HIV. Participants were divided into two experimental groups receiving MBCT and SBRT, respectively, and one control group, selected randomly. Before and after the intervention, questionnaires and CD4+ tests were administered to the participants. Only two experimental groups received the intervention, while the control group received no training. The appropriate training for each group was conducted twice a week over eight sessions and each session lasted 90 minutes. In the intervention groups, all the people participated in all the group training sessions. No intervention was performed for the participants of the control group, and they only completed the questionnaires in the same period as the intervention groups. "Mindfulness-Based Cognitive Therapy" and "Mind Control" books were used for the implementation of MBCT and SBRT, respectively.

Results: It was revealed that a number of male participants constituted the majority with 58 (64.4%) compared to females. Regarding the means of transmission, sexual contact was the most common with 62 (68.8%) compared to other routes. The mean age of the participants was 40.5 ± 10.8 years. For the SBRT group, the mean CD4+ count was higher, with 599.5 ± 290.9 for pretest and 563.2 ± 366.7 for post-test assessments, compared to other groups. After performing the linear regression analysis, it was found that the variables had no effect on the main outcome, which is CD4 count after the intervention (p-value= 0.27). For the MBCT group, the CD4+ count variable had a p-value = 0.10 (pretest: 447.2 ± 19.5, posttest: 411.9 ± 235.9), for the SBRT group, the CD4+ count variable had a p-value = 0.05 (pretest: 599.5 ± 290.9, posttest: 549 ± 259.9), and the control group, the CD4+ count variable had a p-value = 0.5 (pretest: 445 ± 222.7, posttest: 563.2 ± 366.7).

Conclusion: MBCT and SBRT may enhance the mental well-being of PLWH. Therefore, following the interventions, the mean level of SA decreased, and PsyCap increased. Thus, strategies to improve psychological support interventions may have a significant impact on improving the health status of individuals living with HIV, including indicators of SA and PsyCap.