Randomized Controlled Trial of Mindfulness-Based Stress Reduction Delivered to Human Immunodeficiency Virus–Positive Patients in Iran

Abstract

Objective: To evaluate the immediate and long-term effectiveness of mindfulness-based stress reduction (MBSR) on biological and symptomatological markers of health among human immunodeficiency virus-positive (HIV+) patients in Tehran Iran. Methods: Using a randomized controlled trial design data from 173 HIV+ patients (CD4 count > 250) not yet receiving antiretroviral therapy who participated in either an 8-week MBSR (n = 87) or a brief education and support condition (n = 86) at the Imam Khomeini Hospital were analyzed. Assessments included CD4 count Symptom Checklist-90-Revised (SCL-90R) and Medical Symptom Checklist (MSCL) at baseline immediate post-treatment and at the 3- 6- 9- and 12-month follow-up periods. Results: The treatment-adherent sample had a mean (standard deviation) age of 35.1 (6.5) years and 69% were male. Linear mixed-model estimates indicated that in the MBSR condition the mean CD4 count increased from baseline up to 9 months after treatment and then returned to baseline level at 12 months. Improvements in mean SCL-90R (up to 6 months) and MSCL (up to 12 months) scores were observed for the MBSR condition whereas education and support condition scores remained the same over time; however only MSCL improvements significantly differed between groups and these changes lasted up to the final assessment. Conclusions: Findings suggest that among treatment-adherent Iranian HIV+ patients not yet receiving antiretroviral drug treatment MBSR seems to have the strongest potential to improve self-reported medical symptoms.