Comparing the Effectiveness of Cognitive-Behavioral Group Therapy and Mindfulness-Based Cognitive Therapy on Improving Quality of Life and Increasing CD4 Index in HIV/AIDS Patients Under Treatment in Ahvaz City, Iran

One of the chronic diseases is acquired immunodeficiency syndrome (AIDS), an acquired immunodeficiency syndrome. It is a chronic and progressive disease that affects patients' quality of life. The disease has a slow course of development and weakens the immune system. Human immunodeficiency virus (HIV) is the causative agent of AIDS. It is a group of retroviruses that invade and disrupt the cells of the immune system and cause fatal infections. Human immunodeficiency viruses are HIV1 and HIV2, which are cytopathic viruses. HIV–infected people develop symptoms such as fever, sweating, tremor, lymph node swelling, weakness and fatigue, weight loss, chronic diarrhea, blindness, excessive fatigue, and CD4 loss. The infected people are susceptible to AIDS. It can cause various cancers, such as Kaposi's sarcoma, cervical cancer, and lymphoma. AIDS can lead to the involvement of neurological problems and may cause early symptoms of central nervous system failure, depression, forgetfulness, lack of concentration, loss of consciousness, apathy, and decreased desire to have sex and may cause confusion, balance disorder, convulsions, advanced dementia, and coma. AIDS can adversely affect all aspects of life, including physical, social, and family life, and even the family members of these patients may be affected. AIDS is a social and medical issue with widespread negative consequences and challenges. It also poses many negative challenges to individuals' and social lives and undermines social and economic growth worldwide, although its negative consequences cannot be reverted. Iranian researchers found that in infected patients, CD4 cell counts of less than 200 cells per microliter were likely to be infections of the lungs, pulmonary tuberculosis, and brain toxoplasmosis, so cell counts should be performed regularly. The researchers found that as predictors of neuronal hormone factors in developing norepinephrine HIV, depression, hopelessness, and avoidant coping significantly reduced CD4 and increased viral load in patients. Also, cortisol hormone correlated with CD4 count. It may not, but it can predict increased viral load. However, there are different conclusions about the impact of exercise on CD4. Researchers have suggested exercise training in health services to improve the mental health of women with AIDS and found that exercise did not affect CD4 count. Considering the importance of HIV and AIDS, this research investigated the effect of cognitive–behavioral group therapy and mindfulness–based cognitive therapy on improving the quality of life and increasing CD4 count in HIV/AIDS patients.

The present study was quasi–experimental with a pretest–posttest design with a control group. The statistical population includes HIV/AIDS patients referring to Ahvaz Behavioral Counseling Center, Ahvaz City, Iran, in 2019. They were selected by convenience sampling. The sample consisted of three groups of 15 randomly assigned to three groups: cognitive–behavioral therapy, mindfulness–based cognitive therapy, and control group. After implementing a pretest on the cognitive–behavioral and mindfulness groups, the experimental intervention was administered in 8 sessions for one hour and a half one session per week. Quality of Life Scale, CD4 index, and Demographic Factor Questionnaire were used for data collection. Multivariate analysis of covariance was used for data analysis in SPSS.22 software.

The findings showed a statistically significant difference between the three groups of cognitive–behavioral, mindfulness, and control in terms of quality–of–life components (F=8.03, p<0.0001) and CD4 (F=13.85, p<0.0001). These findings suggest that mindfulness therapy is more effective than cognitive–behavioral therapy in improving the quality of life and CD4 of HIV/AIDS patients.

Our study shows that cognitive–behavioral therapy and mindfulness improve the quality of life and CD4 index of AIDS patients, but mindfulness–based cognitive therapy has a greater impact on improving the quality of life and CD4 of AIDS patients.