Cognitive Behavioral Therapy on Adherence to Antiretroviral Medications among People Living with HIV/AIDS (Published)
Antiretroviral therapy (ART) is a life-sustaining treatment for people living with HIV/AIDS (PLWHIV). However, adherence remains a challenge due to various behavioral and psychosocial factors. Cognitive Behavioral Therapy (CBT) has emerged as a potential intervention to improve ART adherence, but its effectiveness is not well-established in diverse contexts. This systematic review comprehensively assesses the impact of CBT on ART adherence among PLWHIV. A systematic search of peer-reviewed literature was conducted using, EBSCO, Medline, Psych Info, PubMed, Scopus, and Web of Science. Studies published between 2013 and 2023 focusing on CBT and ART adherence among PLWHIV were included. Randomized controlled trials, cohort studies, and qualitative studies were analyzed following PRISMA guidelines to synthesize evidence on CBT interventions. A total of 22 studies met the inclusion criteria, comprising 13 randomized controlled trials, 6 cohort studies, and 3 qualitative studies. The sample sizes ranged from 20 to 500 participants, with intervention durations between 4 and 24 weeks and follow-up periods of 6 to 52 weeks. The primary CBT approaches included individual CBT (n=12), group CBT (n=6), CBT with phone reminders (n=2), and CBT with peer support (n=2). Outcome measures assessed included self-reported adherence (n=18), viral load suppression (n=10), and CD4 cell count (n=8). Eighteen studies reported significant improvements in ART adherence (p < 0.05), twelve reported increased viral load suppression (p < 0.05), and eight found improvements in CD4 cell count (p < 0.05). The findings suggest that CBT is an effective intervention in improving ART adherence among PLWHIV. Individual CBT showed slightly better outcomes than group CBT, and CBT combined with phone reminders or peer support enhanced adherence rates. Future research should focus on addressing gaps in youth, adolescents, and resource-limited settings to optimize CBT’s role in ART adherence.
Keywords: ART adherence, Cognitive Behavioral Therapy, HIV/AIDS, antiretroviral therapy, psychosocial support, public health