HIV Related Research

We are conducting trials of the application of supportive/ expressive group psychotherapy to populations with HIV infection or at risk for it. We have gone to special efforts to recruit women with HIV infection. Our initial data indicate that the intervention is quite effective in reducing distress and improving coping. We are currently expanding a study of the effects of two different kinds of psychotherapy for women with histories of sexual or physical abuse who are at risk for HIV infection.

  1. Research to Evaluate the Effects of Group Psychotherapy for People with HIV
  2. Model of Hypercortisolism in Major Depressions
  3. Group Interventions to Prevent HIV in High Risk Women (abstract located under Trauma Studies)
  4. Evaulation of PTSD Program for HIV Positive Persons Attending Two Community Clinics


Research to Evaluate the Effects of Group Psychotherapy for People with HIV

Principal Investigator: Dr. David Spiegel
Project Director: Cheryl Koopman, Ph.D.

Funding: National Institutes of Mental Health, #MH54930

We are evaluating the effects of group psychotherapy intervention on mood, coping, risk behavior, and treatment adherence outcomes among women and men with HIV-related disease. This intervention being evaluated is supportive-expressive group therapy, a program first used with women with metastatic breast cancer. This treatment has also been used with depressed HIV-positive men (Kelly et al., 1993). Evaluation of this intervention is based on changes in psychosocial variables over the course of 12 months after recruitment of 200 men and women infected with HIV in a prospective randomized clinical trial. Half of the subjects are randomly assigned to receive supportive-expressive group therapy plus an educational intervention; the other half are randomly assigned to receive the educational intervention alone. All subjects are assessed at baseline and 3-, 6-, and 12-months. This study allows us to address three major research aims:

  1. Examine the effectiveness of supportive-expressive group therapy plus an educational intervention in comparison to the educational intervention alone in improving the quality of life and promoting health-enhancing behavior of HIV-positive men and women.
  2. Examine mediators of change associated with group treatment.
  3. Identify psychosocial variables that are predictors of outcome.

The results of this study will provide information relevant to three clinical decisions: a) to determine whether or not to use supportive-expressive group therapy to improve psychosocial functioning of HIV-positive people; b) to identify people most likely to benefit from participating in supportive-expressive group psychotherapy; and c) to identify those most in need of psychosocial intervention to promote health-enhancing behavior.


Model of Hypercortisolism in Major Depressions

Co-Principal Investigator: Dr. David Spiegel
Co-Principal Investigator: Dr. Alan Schatzberg
Project Director: Cheryl Koopman, Ph.D.

Funding: National Institutes of Health

The major goal of this project is to examine the potential roles of increased HPA axis activity in treatment adherence and response to treatment among HIV-positivepatients.


Evauation of a PTSD Screening Program for HIV Positive Persons Attending Two Community Clinics

Research Principal Investigator: Cheryl Koopman, Ph.D.
Community Principal Investigator: Dennis Israelski. M.D.
Project Director: Rachel Power, Ph.D.

Sites: San Mateo County Medical Center and Stanford University School of Medicine

Funding Agency: Universitywide AIDS Research Program

This project is an evaluation of a Posttraumatic Stress Disorder (PTSD) screening program designed to assess the prevalence of PTSD symptoms in a sample of HIV-infected men and women attending two community-based clinics. Rates of specific traumatic life events (e.g., child sexual abuse, intimate partner abuse), depressive symptoms and acute stress disorder symptoms are also being examined. The project design involves a collaborative effort between the Stanford University School of Medicine and the San Mateo County Medical Center. As part of the project, participants are referred to appropriate psychiatric and social services if needed, and utilization of the recommended services is examined six months after baseline assessments. HIV positive participants are being consecutively recruited from the Willow Clinic in Menlo Park and the Edison Clinic in San Mateo. The Willow Clinic HIV patient population is 41% female and approximately 70% are African-American and 20% are Hispanic. At the Edison Clinic, 28% are women, 32% are African-American, and 36% are Hispanic. The results from this study will increase understanding of the prevalence of PTSD symptoms and traumatic life events in HIV-infected persons. In addition, the findings will increase awareness of the psychiatric and social work treatment needs of this HIV-positive community. With the help of a Community Advisory Board, we will widely disseminate this information at local community HIV updates as well as through research presentations and publications.

 


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