Grant: Fellowship - PA: Health Services/Population Health HIV/AIDS Research

Progresses in the treatment of HIV/AIDS have resulted in greatly improved life expectancy for people living with HIV/AIDS (PHAs). However, PHAs are more likely to be anxious and depressed, and to have lower quality of life than individuals without HIV. In turn, anxiety and depression contribute to sub-optimal adherence to HIV treatment leading to the development of drug resistance and poorer outcomes. Interventions to reduce depression and anxiety, and to improve treatment adherence are needed. Mindfulness-based stress reduction (MBSR) is an intervention that has demonstrated benefits in other clinical population (e.g., cancer), leading to reduced psychological distress and improved health outcomes. This study will evaluate the efficacy of an MBSR program among PHAs. A group of 120 PHAs who are attending an hospital-based HIV clinic will be randomly assigned to either a 6-week MBSR intervention or to standard care (participants receiving standard care will have an opportunity to take part in MBSR after 6 months). The efficacy of the program will be evaluated using information from PHAs' medical charts (e.g., markers of immune systems function) as well as questionnaires measuring depression, anxiety, and treatment adherence completed before, immediately after MBSR and at a 6-month follow-up. In addition, a sample of PHAs will participate in focus groups to discuss their experience of the program. We expect that MBSR participants will have reduced symptoms of depression and anxiety, better treatment adherence, as well as better quality of life in comparison to participants who receive standard care. If MBSR's effectiveness is demonstrated among PHAs, the program will be translated in different languages and an online module will be developed to increase accessibility. In addition to the immediate benefits to participants, this research may lead to enhanced biopsychosocial care for PHAs, leading to more positive treatment outcomes and a reduction of the burden of HIV.