Effects of cognitive behavioral therapy on people living with HIV and depression: A systematic review and meta-analysis

The aim of this review is to examine the efficacy of cognitive behavioral therapy (CBT) on people living with HIV (PLWH) and depression. A literature search from five electronic databases was conducted, and articles published until July 2017 were collected. The inclusion criteria included randomized controlled trials (RCTs) of CBT that were conducted among PLWH with clinically relevant depression. Comprehensive Meta-Analysis 2 was used to obtain pooled results. Seven RCTs, with a total sample size of 388 participants, met the inclusion criteria. Compared with the control group, the CBT group had statistically significant, short-term improvements in depression (g = -0.486, 95% CI [-0.969 to -0.003], P = 0.048). A significant reduction in viral load was also observed at the long-term follow-up (g = -0.306, 95% CI [-0.573 to -0.040], P = 0.024), but no improvements were found in CD4. Results of this meta-analysis showed that CBT is effective in reducing depression symptoms in PLWH with comorbid depression for a short period of time. However, the findings of this review may not be generalized in the clinical field due to the small number of involved studies and the limited study sample. Thus, more robust and adequately powered studies are needed to further explore CBT interventions in PLWH with depression.