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The Impact of Prolonged Exposure Therapy on Medication Adherence and Quality of Life in People Living with HIV: A Randomized Controlled Trial

pacella, maria lynn
http://rave.ohiolink.edu/etdc/view?acc_num=kent1365808081

Abstract Details

, PHD, Kent State University, College of Arts and Sciences / Department of Psychological Sciences.
People living with HIV (PLWH) display disproportionally high levels of psychopathology (i.e., posttraumatic stress disorder symptoms [PTSS] and depressive symptoms) that may interfere with optimal medication adherence and health-related quality of life (HR-QOL). The adverse consequences of non-adherence and diminished HR-QOL, including reduced length of survival, highlight the need for intervention in PLWH. Though recent research suggests that the removal of psychological barriers (i.e., PTSS and depressive symptoms) may result in improvements in adherence and HR-QOL, this has never been directly tested in PLWH. We previously demonstrated the success of prolonged exposure (PE) therapy at improving PTSS and depressive symptoms in PLWH. The proposed study extends these findings by determining whether PE also impacted self-reported and electronically monitored medication adherence, and self-reported adherence self-efficacy, physical health symptoms, and HR-QOL in 65 PLWH. Participants were randomly assigned to either the PE (n = 40) or weekly monitoring/wait-list control group (n = 25), and completed assessments at baseline, post-treatment, and 3-months post-treatment. Following the 3-month assessment, control group participants were offered the intervention, and all PE recipients completed the 6-month assessment. Multilevel growth curve models were conducted on the completer and intent-to-treat samples using the HLM software, and exploratory mediation analyses were conducted in SPSS. Compared to the controls, PE recipients did not experience direct benefits in self-reported or electronically monitored medication adherence or HR-QOL throughout 3-months post-intervention; however, physical health symptoms improved for participants in both groups, and PE recipients reported increased adherence self-efficacy throughout 3 months. Mediation analyses further demonstrated that the removal of psychological barriers led to better short-term adherence and health.
Douglas Delahanty (Advisor)
Health; Psychology; Psychotherapy; Public Health; Therapy

Recommended Citations

Citations

  • pacella, M. L. (n.d.). The Impact of Prolonged Exposure Therapy on Medication Adherence and Quality of Life in People Living with HIV: A Randomized Controlled Trial [Doctoral dissertation, Kent State University]. OhioLINK Electronic Theses and Dissertations Center. http://rave.ohiolink.edu/etdc/view?acc_num=kent1365808081

    APA Style (7th edition)

  • pacella, maria. The Impact of Prolonged Exposure Therapy on Medication Adherence and Quality of Life in People Living with HIV: A Randomized Controlled Trial . Kent State University, Doctoral dissertation. OhioLINK Electronic Theses and Dissertations Center, http://rave.ohiolink.edu/etdc/view?acc_num=kent1365808081.

    MLA Style (8th edition)

  • pacella, maria. "The Impact of Prolonged Exposure Therapy on Medication Adherence and Quality of Life in People Living with HIV: A Randomized Controlled Trial ." Doctoral dissertation, Kent State University. Accessed AUGUST 14, 2025. http://rave.ohiolink.edu/etdc/view?acc_num=kent1365808081

    Chicago Manual of Style (17th edition)

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This open access ETD is published by Kent State University and OhioLINK.
Release 3.2.12