The Effect of Rational Emotive Behavior Therapy (REBT) on Antiretroviral Therapeutic Adherence and Mental Health in Women Infected with HIV/AIDS
ABSTRACT: to identify the
effectiveness of rational-emotive-behavior-based therapy (REBT-based therapy)
on improved mental health and antiretroviral (ART) therapeutic adherence in
women infected with HIV/AIDS (female subjects with HIV/AIDS). Methods: a
randomized and single-blinded clinical trial in women infected with HIV/AIDS
who had their treatment at the outpatient clinic of Pokdiksus AIDS RSCM and at
the AIDS Comprehensive Diagnostic Unit of Dharmais Hospital was conducted
between October 2011 and March 2012. A block randomization of 160 female subjects
with AIDS was performed that resulted in a REBT-based treatment group (n=80)
and a control group (n=80). The treatment group received REBT-based
intervention of 8 sessions weekly including 6 individual-therapeutic
sessions/week and 2 group-therapeutic sessions /week. Instruments used in the
study were questionnaires on demography, ART adherence (measured by self report
and pill count), and mental health (SRQ-20). Data were analyzed using
Chi-Square test, Generalized Linear Model, and Generalized Estimating
Equations. Results: there were 148 respondents analyzed including in the
REBT-based group (n=72) and in the control group (n=76) with mean age of 33-34
years. After 8 weeks of REBT-based intervention, there was improved (increased)
mean value of the self-reported adherence score (self-report) compared to
control group (100%; CI 95%,83.3-96.7 vs. 84%; CI 95%,77.5-87.8) and improved (decreased)
SRQ-20 mean score in REBT-based treatment group compared to control group (2.9;
CI 95%, 2.7-13.0 vs. 5.4; CI 95%: 5.0.-13.6). ART adherence based on viral load
titer was not analyzed in both group since most of VL titer were undetected
(<400 copies/mL). GLM analysis showed decreased SRQ-20 mean score and
increased mean value of self-reported ART adherence (self-report) in the
REBT-based treatment group, which were more signifcant (p<0.000) than
control group on the 8th week. GEE analysis showed that 1 point decrement of
SRQ-20 would increase self-reported ART adherence as much as 0.722 point and
the correlation was statistically signifcant (p<0.00). Conclusion: after 8
weeks of REBT- based intervention to female subjects with HIV/AIDS, there is a
decrease of SRQ-20 mean score which may result in increased ART adherence mean score
in the treatment group compared to the control.
Author: Surilena dkk
Journal Code: jpkedokterangg140291
