Self-efficacy and distress in women with AIDS: the SMART/EST women's project

Abstract

Though African American and Hispanic women accounted for 14% of the female population in the USA, they represented 66% of the total HIV/AIDS diagnoses among women in 2007. Among men living with HIV, increased coping self-efficacy (SE) following a cognitive behavioral intervention has been related to decreased distress, anxiety, anger, and confusion, but comparable studies had not been carried out with HIV+ women.

The purpose of this study was to examine the impact of changes in SE following a cognitive behavioral stress management plus expressive supportive therapy (CBSM+) intervention on depression and anxiety in low-income urban predominantly minority women living with AIDS. Women (n=451) were randomized to a group CBSM+ or individual informational intervention condition and completed baseline, post-intervention and long-term follow-up (12 months) assessments of depression, anxiety and SE. Women who were assigned to the CBSM+ group condition and increased their level of cognitive behavioral SE reported significant decreases in anxiety and depression at post-intervention and long-term follow-up in comparison with controls who did not improve. Results suggest that both cognitive behavioral skills and a concomitant increase in the perceived level of SE in the use of those skills are predictive of distress reduction.

Keywords:

• self-efficacy
• distress
• women
• AIDS
• group therapy

Acknowledgements

This study was supported by National Institute of Mental Health Grant R01-MH 55463. The authors thank Drs Elizabeth Brondolo, Michael Antoni, and Arthur LaPerriere for their reviews and contributions to this manuscript, as well as the women who participated in this study, without whom none of this work would have been possible.