Background: This study compared the effects of a supportive-expressive group intervention (GI) with an educational control condition (EC) on long-term psychosocial adjustment in gay men with HIV infection. Method: Subjects (n = 85) were randomized after stratification for disease stage and use of antiretroviral medication. GI consisted of 4 months of weekly group sessions followed by 5 monthly maintenance sessions plus written educational material, whereas the EC subjects received educational material only. Results: There were no between-group differences in effects on distress, coping or social support in analyses examining 4 time points over 15 months. Both conditions decreased in distress over time on the Hopkins Symptom Checklist and Beck Depression Inventory. Conclusions: Several explanations are offered for the reason why no additional benefit of the GI was found on outcome measures studied when compared with the EC condition and recommendations are made for future psychosocial intervention research with HIV-infected persons.

Keywords:
HIV infection, Psychosocial adjustment, Randomized trial, Group intervention, Gay men
1.
Chesney M, Folkman S, Chambers D: Coping effectiveness training for men living with HIV: Preliminary findings. Int J STD AIDS 1996;7(suppl 2):75–82.
2.
Kelly JA, Murphy DA, Bahr GR, Kalichman SC, Morgan MG, Stevenson LY, Koob JJ, Brasfield TL, Bernstein BM: Outcome of cognitive-behavioral and support group brief therapies for depressed, HIV-infected persons. Am J Psychiatry 1993;150:1679–1686.
3.
Markowitz JC, Kocsis JH, Fishman B, Spielman LA, Jacobsberg LB, Frances J, Klerman GL, Perry SW: Treatment of depressive symptoms in human immunodeficiency virus-positive patients. Arch Gen Psychiatry 1998;55:452–457.
4.
Antoni MH, Baggett L, Ironson G, LaPerriere A, August S, Klimas N, Schneiderman N, Fletcher MA: Cognitive-behavioral stress management intervention buffers distress responses and immunologic changes following notification of HIV-1 seropositivity. J Consult Clin Psychol 1991;59:906–915.
5.
Goodkin K, Blaney NT, Feaster DJ, Baldewicz T, Burkhalter JE, Leeds B: A randomized controlled clinical trial of a bereavement support group intervention in human immunodeficiency virus type 1-seropositive and -seronegative homosexual men. Arch Gen Psychiatry 1999;56:52–59.
6.
Auerbach JE, Oleson TD, Solomon GF: A behavioral medicine intervention as an adjunctive treatment for HIV-related illness. Psychol Health 1992;6:325–334.
7.
Coates TJ, McKusick L, Kuno R, Stites DP: Stress reduction training changed number of sexual partners but not immune function in men with HIV. Am J Public Health 1989;79:885–887.
8.
Lutgendorf SK, Antoni MH, Ironson G, Klimas N, Kumar M, Starr K, McCabe P, Cleven K, Fletcher MA, Schneiderman N: Cognitive-behavioral stress management decreases dysphoric mood and herpes simplex virus-type 2 antibody titers in symptomatic HIV-seropositive gay men. J Consult Clin Psychol 1997;65:31–43.
9.
Mulder CL, Emmelkamp PMG, Antoni MH, Mulder JW, Sandfort TGM, de Vries MJ: Cognitive-behavioral and experiential group psychotherapy for HIV-infected homosexual men: A comparative study. Psychosom Med 1994;56:423–431.
10.
Lutgendorf SK, Antoni MH, Ironson G, Starr K, Costello N, Zuckerman M, Klimas N, Fletcher MA, Schneiderman N: Changes in cognitive coping skills and social support during cognitive behavioral stress management intervention and distress outcomes in symptomatic human immunodeficiency virus (HIV)-seropositive gay men. Psychosom Med 1998;60:204–214.
11.
Mulder CL, Antoni MH: Acquired Immunedeficiency Syndrome (AIDS) in homosexual men: Psychological distress and psychotherapy. Clin Psychol Psychother 1994;1:69–81.
12.
Weiss JJ: Psychotherapy with HIV-positive gay men: A psychodynamic perspective. Am J Psychother 1997;51:31–44.
13.
Zuckerman MJ, Antoni MH: Social support and its relationship to psychological, physical health and immune variables in HIV infection. Clin Psychol Psychother 1995;2:210–219.
14.
Centers for Disease Control and Prevention: 1993 revised classification system for HIV infection and expanded surveillance case definition for AIDS among adolescents and adults. MMWR Morbid Mortal Wkly Rep 1992;41:1–19.
15.
Yalom ID: The Theory and Practice of Group Psychotherapy, ed 4. New York, Basic Books, 1995.
16.
Vandenbruaene M (ed): Positief leven: Een gids voor seropositieven en hun omgeving. Antwerp, Uitgeverij Hadewijch, 1993.
17.
Derogatis LR, Lipman RS, Rickels K, Uhlenhuth EH, Covi L: The Hopkins Symptom Checklist (HSCL): A self-report symptom inventory. Behav Sci 1974;19:1–15.
18.
Beck AT, Ward CH, Mendelson M, Mock J, Erbaugh J: An inventory for measuring depression. Arch Gen Psychiatry 1961;4:561–571.
19.
Markowitz JC, Klerman GL, Clougherty KF, Spielman LA, Jacobsberg LB, Fishman B, Frances AJ, Kocsis JH, Perry SW: Individual psychotherapies for depressed HIV-positive patients. Am J Psychiatry 1995;152:1504–1509.
20.
McNair DM, Lorr M, Droppleman LF: EDITS manual for the Profile of Mood States. San Diego, EDITS, 1971.
21.
Wald FDM, Mellenbergh GJ: De verkorte versie van de Nederlandse vertaling van de Profile of Mood States (POMS). Ned Tijdschr Psychol 1990;45:86–90.
22.
Carver CS, Scheier MF, Weintraub JK: Assessing strategies: A theoretically based approach. J Pers Soc Psychol 1989;56:267–283.
23.
Mulder CL, Antoni MH, Emmelkamp PMG, Veugelers PJ, Sandfort TGM, van de Vijver FAJR, de Vries MJ: Psychosocial group intervention and the rate of decline of immunological parameters in asymptomatic HIV-infected homosexual men. Psychother Psychosom 1995;63:185–192.
24.
Sarason IG, Sarason BR, Shearin EN, Pierce GF: A brief measure of social support: Practical and theoretical implications. J Soc Pers Relat 1987;4:497–510.
25.
HIV Stressful Life Events Questionnaire. Utrecht, Nederlands Centrum Geestelijke Volksgezondheid, 1991.
26.
Sarason IG, Johnson JH, Siegel JM: Assessing the impact of life changes: Development of the Life Experiences Survey. J Consult Clin Psychol 1978;46:932–946.
27.
Beck AT, Steer RA, Garbin MG: Psychometric properties of the Beck Depression Inventory: Twenty-five years of evaluation. Clin Psychol Rev 1988;8:77–100.
28.
Edmonds CVI, Lockwood GA, Cunningham AJ: Psychological response to long-term group therapy: A randomized trial with metastatic breast cancer patients. Psychooncology 1999;8:74–91.
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2003
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