Developing and Pilot Testing a Brief Intervention to Reduce Psychological Distress among Individuals Recently Diagnosed with HIV in China

Abstract

In China, where there are few mental health resources, the majority of HIV-related efforts have focused on medical treatment and transmission prevention rather than psychosocial support. Yet people living with HIV/AIDS (PLWHA) report high levels of psychological distress, especially upon first receiving their HIV diagnosis. We conducted mixed methods research of a qualitative study with (N = 31) individual interviews and 3 focus groups (n = 6 in each group), and a quantitative survey (N = 200) with HIV affected participants in Shanghai and Beijing, China. Our findings informed the development of the Psychology Toolbox intervention, a brief CBT skills-based intervention comprising an Automatic Thought Record, Behavioral Activation, and Paced Breathing, designed to be integrated into primary care for recently diagnosed PLWHA. Recently diagnosed Chinese PLWHA who are men who have sex with men (MSM) are particularly vulnerable to psychological distress as they face both HIV and sexual orientation stigma. We conduct a pilot Type 1 hybrid effectiveness-implementation trial (Curran et al., 2012) of the Psychology Toolbox intervention with recently diagnosed MSM for mental health outcome data as well as feasibility and acceptability information. Ten recently diagnosed MSM at an HIV treatment center in Shanghai China completed the intervention. Paired-samples t tests demonstrate significant reduction in HIV-related distress, depression, problems with adjustment, as well as improvements in coping and perceived social support. Participants found the intervention highly acceptable. Community advisory board members of nurses, physicians, and community peer leaders along with attrition data suggest that the intervention is feasible. Future research may seek implement the intervention in a larger sample as well as among other recently HIV diagnosed populations.