Brief Report: Evaluating the Efficacy of Psychobehavioral Interventions for Cardiovascular Risk Among People Living With HIV: A Systematic Review and Meta-Synthesis of Randomized Controlled Trials.

Supplemental Digital Content is Available in the Text. People with HIV (PWH) are disproportionately affected by cardiovascular disease (CVD). Psychobehavioral therapies are capable of targeting the pathophysiology underlying HIV-CVD comorbidity. This study synthesized findings from randomized controlled trials of psychobehavioral therapies for reducing CVD risk among PWH following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Inclusion criteria were as follows: (1) used a randomized controlled trial design, (2) evaluated a cognitive–behavioral or mindfulness-based therapy, (3) sampled adults (age ≥18 years) with HIV, (4) measured a behavioral (eg, diet) or biological (eg, immune functioning) CVD risk factor, and (5) published in an English-language peer-reviewed journal. Electronic searches were conducted in 6 databases (eg, MEDLINE) using controlled vocabulary and free-text synonyms for HIV, psychobehavioral therapy, and CVD risk. Data were independently extracted with consensus reached. Outcomes were immune activation, tobacco smoking, stress, inflammation, and physical activity from 33 studies. There were stronger effects for psychobehavioral interventions compared with controls on CD4 [Hedge g = 0.262, 95% confidence interval (CI) = 0.127 to 0.396] and tobacco-smoking abstinence (Hedge g = 0.537, 95% CI = 0.215 to 0.86). There were no differences or insufficient data for stress, inflammation, or physical activity. No eligible studies examined psychobehavioral interventions on blood pressure, lipids, or weight in PWH. There is increasing importance to further invest in broader CVD risk reduction effort for PWH that include psychobehavioral intervention strategies. [ABSTRACT FROM AUTHOR]