Telephone Based Cognitive Behavioral Therapy for HIV Related Depression

Up to 40% of individuals receiving medical care for HIV meet DSM-IV criteria for
co-occurring depressive disorder. Individuals with HIV and depressive disorders, compared to
those with HIV alone, have been shown to have worse adherence to taking antiretroviral
medication, increased HIV related morbidity and among women a higher mortality. Previous
research suggests that mental health interventions may lead to improved depressive and HIV
related outcomes. However because many HIV infected depressed individuals may have trouble
accessing mental health services, there is an urgent need for treatment trials to assess
whether treatment of depression targeting patients in urban HIV care settings will result in
both improved depressive and HIV related outcomes. The goal of this project is to test the
preliminary effectiveness of an adapted telephone-based, cognitive behavioral therapy (CBT)
intervention targeting HIV infected depressed individuals receiving care in adult outpatient
HIV clinics. A total of 60 HIV infected, depressed individuals receiving care at an urban,
outpatient HIV clinic will be randomly assigned to receive either the telephone
psychotherapy intervention or enhanced usual care with non-specific telephone contact. The
results will provide preliminary data on whether the telephone psychotherapy intervention
for HIV infected depressed individuals is effective in reducing depression. The results will
also be used to determine feasibility, accessibility, and whether the intervention leads to
improved retention and better satisfaction.

Inclusion Criteria:

- Has a DSM-IV diagnosis of a Depressive Disorder as measured by the mood battery of
the MINI

- Has a diagnosis of HIV and is receiving HIV related outpatient care at the Evelyn
Jordan Center in Baltimore, MD

- Is able to speak English

- Is able to read English on approximately the 6th grade reading level or higher as
measured by the Wide Range Achievement Test 4 (WRAT-4) or by self-report

- Is at least 18 years old

- Has access to a telephone

Exclusion Criteria:

- Meets criteria for dementia by scoring below 10 on the Hopkins HIV Dementia Scale

- Shows signs of serious psychiatric pathology that might either be due to an organic
etiology other than HIV, or would generally not be considered treatable solely with
psychotherapy, or for whom participation in this protocol might be considered
dangerous or unethical

- has a history of serious suicide attempts or is severely suicidal (has ideation,
plan, and intent) determined by the MINI

- Patients in psychotherapy are excluded because it is confounded with the study
treatments