Health  Vol.4 No.12 , December 2012
Cognitive behavioral therapy group intervention for HIV transmission risk behavior in perinatally infected adolescents
Abstract: Purpose: This study analyzed treatment effects of cognitive behavioral therapy (CBT) group counseling intervention on HIV transmission risk behavior, depression, anxiety, and alcohol use in HIV perinatally infected adolescents attending an HIV clinical care center in Uganda, Africa. Method: A total of 186 adolescents were randomly assigned to an experimental or control arm and assigned into groups of 11 - 16 adolescents. The experimental groups received an 80-minute CBT based weekly intervention for 8 consecutive weeks, while the control groups received only standard group care. Data from self report assessments were analyzed at pre- and post-test using repeated measures of analysis of variance. The participants, analyzed by variable, included 115 for sexual behavior, 106 for depression, 88 for anxiety, and 115 for alcohol use. Results: The results from the study show a large significant difference (p = 0.006) between the experimental and control groups on the anxiety variable. There were no significant differences between the experimental and control groups on the variables of sexual behavior (p = 0.876), depression (p = 0.700), and alcohol use (p = 0.815). There was an indication of reduced levels of HIV sexual transmission risk behavior, depression, and alcohol use levels in the participants in both the experimental and control groups. Conclusions: Risky sexual behavior places HIV perinatally infected adolescents at risk of re-infection, sexually transmitted diseases, and transmitting HIV to their sexual partners. CBT group counseling intervention equipped the participating adolescents with appropriate life skills to deal with psychological distress and anxiety often seen in their lives and may be useful in routine medical care to reduce transmission risks and improve wellness and call for its incorporation into HIV preventive programs and counselor education.
Cite this paper: Senyonyi, R. , Underwood, L. , Suarez, E. , Musisi, S. and Grande, T. (2012) Cognitive behavioral therapy group intervention for HIV transmission risk behavior in perinatally infected adolescents. Health, 4, 1334-1345. doi: 10.4236/health.2012.412195.

[1]   Joint United Nations Program on HIV/AIDS, World Health Organization (2010) Global report: UNAIDS report on the global AIDS epidemic 2010.

[2]   Uganda (2010) United National General Assembly special session on HIV. Country Progress Report, Kampala.

[3]   Ezeanolue, E.E., Wodi, A.P., Patel, R. et al. (2006) Sexual behaviors and procreational intentions of adolescents and young adults with perinatally acquired human immunodeficiency virus infection: Experience of an urban tertiary center. Journal Adolescent Health, 38, 719-725. doi:10.1016/j.jadohealth.2005.06.015

[4]   Bakeera-Kitaka, S., Nabukeera-Barungi, N., Nostlinger, C., et al. (2008) Sexual risk reduction needs of adolescents living with HIV in a clinical care setting. AIDS Care, 20, 426-433. doi:10.1080/09540120701867099

[5]   Monasch, R. and Mahy, M. (2006) Young people: The centre of the HIV epidemic. In: Ross, D.A., Dick, B. and Ferguson, J., Eds., Preventing HIV/AIDS in Young People: A Systematic Review of the Evidence from Developing Countries: WHO Technical Report Series. UNAIDS Interagency Task Team on Young People, World Health Organization, Geneva, 15-41.

[6]   Birungi, H., Mugisha, J. F., et al. (2008) Sexual and reproductive health needs of adolescents perinatally infected with HIV in Uganda. Population Council, Washington.

[7]   Musisi, S., Kinyanda, E., Nakasujja, N., et al. (2007) A comparison of the behavioral and emotional disorders of primary school-going orphans and non-orphans in Uganda. Africa Health Science, 7, 202-213.

[8]   Nicolaou, D.C. (2007) Secondary prevention for HIV-positive adolescents: Psychosocial functioning, health promoting factors, and disease control.

[9]   Wingwood, G., DiClemente, R.J., Mikhail, I., et al. (2004) A randomized controlled trail to reduce HIV transmission risk behaviors and sexually transmitted diseases among women living with HIV: The willow program. Journal of Acquired Immune Deficiency Syndromes, 37, 58-67. doi:10.1097/01.qai.0000140603.57478.a9

[10]   Choi, K.H., Lew, S., Vittinghoff, E., et al. (1996)The efficacy of brief group counseling in HIV risk reduction among homosexual Asian and Pacific Islander men. AIDS, 10, 81-87. doi:10.1097/00002030-199601000-00012

[11]   Corey, G. (2000) Theory and practice of group counseling. Brooks Cole, Belmont.

[12]   Rice, A.H. (2004) Group treatment of depression. In: DeLucia-Waack, D.A., et al., Eds., Handbook of Group Counseling & Psychotherapy, Sage, Thousand Oaks, 532-546.

[13]   Mildmay Uganda. (2012).

[14]   Kovacs, M. (2003) Children’s depression inventory: Technical manual update. Multi-Health Systems, North Tonawanda.

[15]   Reynolds, C.R. and Richmond, B.O. (2008) Revised children’s manifest anxiety scale. 7th Edition, Western Psychological Services, Los Angeles.

[16]   Babor, T.F., Higgins-Biddle, J.C., Saunders, J.B., et al. (2001) The alcohol use disorders identification test: Guidelines for use in primary care. 2nd Edition, World Health Organization, Geneva.

[17]   Rotherum-Borus, M.J., Lee, M.B., Birnbaum, J.M., et al. (2001) Efficacy of a preventive intervention for youths living with HIV. American Journal of Public Health, 91, 400-405. doi:10.2105/AJPH.91.3.400

[18]   LifeWay. (2001-2011) True love waits.

[19]   Uganda Bureau of Statistics (UBOS) and Macro International, Inc. (2007) Uganda demographic and health survey 2006. UBOS and Macro International, Calverton.

[20]   Bakeera-Kitaka, S., McKellar, M., Snider, C., et al. (2008) Antiretroviral therapy for HIV-1 infected adolescents in Uganda: Assessing the impact on growth and sexual maturation. The Journal of the Pediatric Infectious Diseases Society, 3, 97-104.

[21]   Bauermeister, J.A., Elkington, K., Brackis-Cott, E., et al. (2009) Sexual behavior and perceived peer norms: Comparing perinatally HIV-infected and HIV-affected youth. Journal of Youth Adolescents, 38, 1110-1122. doi:10.1007/s10964-008-9315-6

[22]   Brogly, S.B., Watts, D.H., Ylitalo, N., et al. (2007) Reproductive health of adolescent girls perinatally infected with HIV. American Journal of Public Health, 97, 1047-1052. doi:10.2105/AJPH.2005.071910

[23]   Musisi, S. and Kinyanda, E. (2009) The emotional and behavioral disorders in HIV seropositive adolescents in urban Uganda. East African Medical Journal, 86, 16-24. doi:10.4314/eamj.v86i1.46923

[24]   Bailey, S.L., Pollock, N.K., Martin, C.S., et al. (1999) Risky sexual behaviors among adolescents with alcohol use disorders. Journal Adolescent Health, 25, 179-181. doi:10.1016/S1054-139X(99)00023-3

[25]   Langer, L.M., and Tubman, J.G. (1997) Risky sexual behavior among substance-using adolescents: Psychosocial and contextual factors. American Journal of Orthopsychiatry, 67, 315-322. doi:10.1037/h0080235