Enhancing well-being and alleviating depressive symptoms in people with HIV/AIDS : an intervention based on ifthen plans with self-affirming cognitions

Effective antiretroviral treatment has increased the life expectancy of people living with HIV, and currently, the challenges of prominent importance appear to be mental health issues. This preregistered study among adults living with HIV/AIDS investigated the effectiveness of a brief self-affirmation intervention framed in terms of if–then plans (i.e. self-affirming implementation intentions [S-AII]) against both active and non-active control conditions, forming non-affirming implementation intentions and mere goal intentions, respectively. The primary outcomes were defined as a reduction of depressive symptoms and enhancement of well-being, along with secondary outcomes as positive other- and self-directed feelings. A total of 162 individuals were assessed for eligibility, and 130 (aged 18–74 years) were randomized to the study conditions. Intervention effects were estimated through intention-to-treat analysis, using linear mixed models. The S-AII intervention yielded improvements in overall well-being over 2 weeks (d = .23), primarily driven by positive changes in emotional (d = .24) and social (d = .30) dimensions of well-being. There were no significant differences in depression or secondary outcomes. Based on a minimal clinically important difference index, the S-AII intervention resulted in improvement in well-being in approximately 40 percent of participants. Nevertheless, further systematic research is needed to optimize self-affirmation-interventions, before their application in real-life contexts.