Assessing the effectiveness and appropriateness of a Cognitive-Behavioral Stress Management intervention for African American HIV+HPV+ women

This study examined the impact of a 10-week Cognitive Behavioral Stress Management (CBSM) intervention on depression, positive states of mind, benefit finding and coping in African American women co-infected with Human Immunodeficiency Virus (HIV) and Human Papilloma Virus (HPV). Dosage effects, CBSM practice effects, and group mastery were analyzed for their impact on these outcomes. The study also explored self-perceived subjective socioeconomic status (SES) and examined the relationship between a retrospective measure of subjective social status and psychological outcomes following the intervention.Participants were 52 HIV+HPV+ African American women who did not meet CDC AIDS defining criteria. The mean age was 30 years of age ( SD = 8.39) and the mean number of years of education was 11.62 (SD = 1.4). The majority of the women were single/never married (58%), currently unemployed (56%) and reported an annual income of less than $12,000 (57%). A demographically similar group of HIV+ women was added because of the small sample size, and utilized for the purposes of measurement reliability analyses and qualitative analyses only.Depression was measured using the Center for Epidemiologic Studies Depression Scale (CES-D). Positive states of mind was measured utilizing the Positive States of Mind Scale (PSOM). Benefit finding was measured using the Benefit Finding Scale (BFS). Coping subscales were measured using the Brief Cope HIV Scale. During the CBSM group, attendance and completion of homework were documented to measure dosage and practice effects, respectively.Members of the CBSM group showed significant decreases in utilization of denial as a coping strategy at the end of the 10-week CBSM program compared to controls. Better attendance and more perceived mastery of skills were associated with greater PSOM scores, fewer depression symptoms and less use of denial and behavioral disengagement. More practice of skills was associated with greater PSOM scores, increased active coping, fewer depression symptoms and less denial and behavioral disengagement. Changes in subjective social status were associated with changes in PSOM scores, denial, and behavioral disengagement over time. Qualitative data indicated that increased subjective social status was reflected in increases in empowerment, return to school/work, improved finances, and increased community involvement