RCT of Mindfulness-Based Stress Reduction Delivered to HIV+ Patients in Iran: Effects on CD4+ T Lymphocyte Count and Medical and Psychological Symptoms

Objective To evaluate the immediate and longer-term effectiveness of Mindfulness-based Stress Reduction (MBSR) among treatment adherents on CD4+ T Lymphocyte Count (CD4 count) and medical and psychological symptoms among HIV + patients in Tehran, Iran. Methods Using a randomized controlled trial design, data were analyzed 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 (ESC) (n=86) at the Imam Khomeini Hospital. Assessments included CD4 count, Symptom Checklist-90-Revised (SCL-90R), and Medical Symptom Checklist (MSCL) at baseline, immediate post-test, and 3, 6, 9 and 12-month follow-up periods. Results The treatment adherent sample had a mean age of 35.1( SD = 6.5) years and 69% were male. Linear mixed model estimates indicated mean CD4 count increased from baseline up to 9 months post-treatment, 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 while ESC 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 appears to have the strongest potential to improve self-reported physical symptomatology. Trial Registration Iranian Registry of Clinical Trials IRCT201106084076N2.