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Publication Profiles

Forty-Eight Week Outcomes of a Site-Randomized Trial of Combined Cognitive Behavioral Therapy and Medication Management Algorithm for Treatment of Depression Among Youth With HIV in the United States

Citation

Brown LK, Baltrusaitis K, Kennard BD, et al. Forty-Eight Week Outcomes of a Site-Randomized Trial of Combined Cognitive Behavioral Therapy and Medication Management Algorithm for Treatment of Depression Among Youth With HIV in the United States. J Acquir Immune Defic Syndr. 2022;91(3):296-304. doi:10.1097/QAI.0000000000003058

Implementation stage:

Sustainment

Implementation outcomes reported:

Appropriateness, Feasibility, Sustainability

Continuum target addressed:

Not reported

Geography:

Non-priority jurisdiction

Study Participant Classification:

Recipients of care

Plain Language Objectives

The researchers wanted to learn whether benefits from a structured depression treatment for young people with HIV continued after the main intervention period. They compared counseling plus guided medication management with enhanced usual care through 48 weeks.

Plain Language Abstract

Depression is common among young people with HIV, and benefits from treatment may fade over time. This site-randomized trial tested whether a structured approach combining cognitive behavioral therapy with a measurement-guided medication plan produced longer-lasting improvement than enhanced usual care. Thirteen U.S. clinical research sites enrolled 156 participants ages 12–24 with ongoing nonpsychotic depression. Sites were assigned to the tailored combined program or to enhanced care that also offered psychotherapy and medication management. At week 36, the average site-level proportion showing a treatment response was 52.0% in combined-program sites versus 18.8% in comparison sites; remission was 37.9% versus 19.4%, and average depression scores were lower. At week 48, the response advantage remained: 58.7% versus 33.4%. The authors concluded that improvements previously observed at week 24 remained evident through weeks 36 and 48. Because entire sites rather than individuals were assigned, and outcomes were compared using site-level averages, interpretation should reflect the study’s design and participating clinical network.

Key Takeaways

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