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Abstract

Grant Number:	5R01DA018603-02
Project Title:	CBT for depression & adherence in HIV methadone patients

PI Information:	Name	Email	Title
	SAFREN, STEVEN A.	ssafren@partners.org	ASSOCIATE PROFESSOR

Abstract: DESCRIPTION (provided by applicant): Overview. Patients with HIV, depression, and opioid-dependence are at high risk for poor health outcomes. This is a two-arm randomized controlled trial of cognitive-behavioral therapy for depression and HIV medication adherence in patients with opioid dependence who are receiving methadone maintenance treatment. The project is based on our pilot work with close attention to NIDA guidelines for a staged approach to treatment development and testing. Background. Depression is highly co-morbid with both HIV infection and with opioid dependence. Depression and substance abuse are both associated with poor adherence to antiretroviral medications. Patients with HIV, depression, and opioid dependence are at high risk for poor health outcomes. Cognitive behavioral therapy is the most widely studied and efficacious psychosocial intervention for depression; and research by the PI and others has shown that cognitive-behavioral interventions have been successful in promoting adherence to HIV medications. Conceptual Model: Symptoms of depression (i.e. low motivation, poor concentration, loss of interest, sad mood, suicidal ideation) that occur in the context of substance abuse or dependence can interfere with self-care behaviors necessary for maintaining HIV care, as well as interfere with potential benefit from an intervention that focuses on adherence alone. We hypothesize that teaching skills to cope with depression will improve the outcome from an adherence intervention to promote healthier living with HIV, in HIV+ opiate dependent individuals in methadone maintenance treatment. Overview of Research Plan. Patients who are HIV positive and who are receiving methadone maintenance for opioid dependence will be randomized to treatment with either: (1) "CBT," a combination of CBT for depression and HIV medication adherence, including a single session intervention for HIV medication adherence in conjunction with physician feedback regarding baseline study assessments or (2) the single session intervention for HIV medication adherence in conjunction with physician feedback regarding baseline study assessments. Participants will be followed for one-year post-randomization.

Public Health Relevance:
This Public Health Relevance is not available.

Thesaurus Terms:
AIDS therapy, cognitive behavior therapy, comorbidity, depression, drug abuse chemotherapy, human therapy evaluation, methadone, therapy compliance
antiAIDS agent, antiviral agent, coping, drug addiction, gender difference, high risk behavior /lifestyle, longitudinal human study, opiate alkaloid, racial /ethnic difference, social support network, substance abuse related behavior
adult human (21+), behavioral /social science research tag, clinical research, human subject, patient oriented research

Institution:	MASSACHUSETTS GENERAL HOSPITAL
	Partners Research Management
	BOSTON, MA 02199
Fiscal Year:	2005
Department:
Project Start:	05-SEP-2004
Project End:	30-JUN-2009
ICD:	NATIONAL INSTITUTE ON DRUG ABUSE
IRG:	ZRG1

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