J Caring Sci, 2023, 12(2), 94-102

doi: 10.34172/jcs.2023.30726
https://jcs.tbzmed.ac.ir TUOMS
PRESS

Review Article

Psychosocial Interventions by Nurses for Patients with HIV/

AIDS: A Systematic Review
ID ID ID
Malihe Davoudi1 , Abbas Heydari2 , Zahra Sadat Manzari2*
Student Research Committee, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran
1

Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Mashhad University of Medical Sciences,
2

Mashhad, Iran

Article Info Abstract

Article History: Introduction: Providing psychological support is one of the traditional roles of nurses for
Received: May 11, 2022 patients with HIV/AIDS. Searching the literature showed that various psychological interventions
Accepted: July 5, 2022 have been performed by nurses to support HIV/AIDS patients; however, no summary of these
e-Published: April 26, 2023 interventions is available. We aimed to systematically review the interventional studies which
investigated the effectiveness of psychosocial interventions delivered by nurses to HIV/AIDS
Keywords: patients.
HIV/AIDS, Nurses, Psychology, Methods: This systematic review was performed based on Cochrane’s handbook of systematic
Systematic review reviews of interventional studies. Preferred Reporting Items for Systematic Reviews and Meta-
Analyses (PRISMA) statement were used in this study. The databases of PubMed, Web of
Corresponding Author: Science, Cochrane, Scopus and World Health Organization were searched from January 2009
Zahra Sadat Marzari, to December 2022. Based on inclusion criteria, nine studies included in this systematic review.
Email: ManzariZ@mums.ac.ir Cochrane data extraction form was used for the systematic review and the article’s information
was summarized using the modified Jadad scale.
Results: The interventions provided by the nurses included: virtual and face-to-face educational
programs, written information resources, palliative care, motivational interview, case
management, home visit, and care services, along with face-to-face and telephone follow-up.
These interventions have a significant positive effect on the quality of life and management
of high-risk behaviors, disease management, symptoms and complications, adherence to
treatment, immune function, and mental health in patients with HIV/AIDS.
Conclusion: The results of the present study show that despite the fact that the interventions
have a purely psychological content and can be done with various methods, they are able to
have positive consequences in physical, psychological, behavioral, and laboratory health in
HIV/AIDS patients.

Introduction health disorders such as depression, anxiety, suicide, and

Despite the ongoing attempts to cure and prevent AIDS/ drug abuse.7 So, performing psychological interventions
HIV, this disease remains one of the major health challenges is needed.8
worldwide.1 AIDS/HIV affects all aspects of a person’s Since nurses are more firmly and continuously connected
quality of life, including physical, psychological, social, to the patients, they have the main role in the care of
and spiritual aspects.2 Patients with HIV/AIDS experience patients with AIDS/HIV.9,10 Therefore, their performance
significant medically and psychologically suffering.3 may affect the patients’ treatment and satisfaction.11 One
There is a two-way and complex relationship between of the traditional roles and responsibilities of nurses is to
psychological health and the problems of these patients. provide psychological support. In holistic nursing care,
HIV and associated infections can cause nerve damage.4 psychological support is essential for healing of patients.12
On the other hand, psychological health problems can Psychological support includes any support to help
be caused by antiviral treatment or the social stigma, them improve their psychological, cognitive, emotional,
stress, and economic and social consequences associated and behavioral well-being. Psychological support is
with treatment process.5 Psychological problems can provided by a wide range of professional groups, peers,
negatively affect the adherence to antiviral treatment and informal providers, both in the clinical setting and
and development of AIDS and consequently poorer in the community.13 Psychological support helps patients
health outcomes.6 HIV patients compared to the general make informed decisions, better cope with disease, and
population are more likely to develop psychological better deal with discrimination. Moreover, psychological
© 2023 The Author(s). This work is published by Journal of Caring Sciences as an open access article distributed under the terms of the Creative
Commons Attribution License (http://creativecommons.org/licenses/by-nc/4.0/). Non-commercial uses of the work are permitted, provided the
original work is properly cited.
 Psychological interventions for HIV/AIDS

support improves the quality of life of patients with HIV studies.14 The PRISMA statement (Preferred Reporting
and prevents further transmission of HIV infection. Items for Systematic Reviews and Meta-analysis) was used
Besides, this type of support is important for patients in this study.15
with AIDS/HIV to follow antiretroviral therapy and Search strategy was based on PICO (Participants,
ongoing counseling to strengthen adherence to treatment intervention, comparison, and outcomes). The participants
regimens.2 were patients with HIV/AIDS, the intervention was
Searching the literature showed that various psychological interventions, comparisons were routine
psychological interventions have been performed by nurses management (i.e., routine care and standard medical
to support patients with AIDS/HIV, but no summary care) or no intervention, and outcomes were the effects
of these interventions is available. The implications of of the intervention on the physical, psychological, social,
these interventions are also unclear. Therefore, this study and other dimensions of the life of patients with AIDS/
was performed aimed to review and summarize the HIV. Literature searches were performed in the databases
psychological interventions provided by nurses to patients of PubMed, Web of Science, Scopus, Cochrane, and the
with AIDS/HIV. This study increases our knowledge of World Health Organization clinical trials registration
the psychological interventions which nurses can directly system) from 2009 to December 2022. The seminars,
provide to patients with AIDS/HIV. The present study also conferences, congresses, and journals were more searched.
increases nurses’ awareness of the primary and secondary If needed, the researcher contacted the corresponding
consequences of these interventions. Moreover, by author for access to the full text of the article. Keywords
knowing the possible consequences of each intervention, were based on the mesh that included: Psychological
nurses can choose the appropriate intervention according intervention, Mental intervention, Nursing, HIV, AIDS,
to the available options and the patients’ preferences. acquired immune deficiency syndrome, and Human
The novelty and innovative aspects of this study is that, immunodeficiency virus and combination of them using
to the best of our knowledge, this is the first systematic Boolean operators (OR, NOT, AND) (Table 1).
review which summarizes and highlights the outcomes Other citations from the original articles and systematic
of psychological interventions performed by nurses on reviews were also searched and evaluated. After the initial
various aspects of the lives of patients with AIDS/HIV. evaluation, duplicate studies were excluded. Then, the
This study also distinguished the types of psychological abstracts of the articles were reviewed and those which
intervention approaches which are commonly used did not coincide with the inclusion criteria were excluded.
by nurses. Moreover, the results of psychological The full text of the remaining studies was re-evaluated.
interventions were summarized. Our conclusions from Finally, nine studies were analyzed (Table 2).
the collected data provide positive strategies and new The inclusion criteria were: Original articles with
practical evidence for psychological support of patients psychological interventions delivered directly by the
with AIDS/HIV that can be applied in clinical practice. nurse, English articles published in between 2009 and
This review was a comprehensive, detailed, and systematic 2022, randomized clinical trial, experimental or Semi-
search of the literature. This study aimed to systematically experimental study, and access to the full-text file. Also,
review the interventional studies which investigated the the exclusion criteria were: pilot study, articles published
effectiveness of psychosocial interventions delivered by in several sources, articles in the low-quality source, letters
nurses to patients with HIV/AIDS. to the editor, articles without abstract, studies that were
not conducted on patients with HIV/AIDS, and a study in
Material and Methods which psychological interventions were not implemented
This systematic review was performed based on Cochrane’s directly by nurses. In this review, all studies have been
handbook of systematic reviews of interventional conducted based on 4 stages of PRISMA (Figure 1).
Table 1. An example of a database search strategy

Database Search strategy

Search field; title; search term ("psychological intervention" or "mental intervention") AND ("HIV" OR "AIDS" OR "Human immunodeficiency virus"
Web of
OR "acquired immune deficiency syndrome")
science
Limits; restricted to articles, nursing, English, open access

Search: ("psychological intervention"[Title/Abstract] OR "mental intervention"[Title/Abstract]) AND nurse*[Title/Abstract] AND (HIV[Title/Abstract]

PubMed OR AIDS[Title/Abstract] OR "Human immunodeficiency virus"[Title/Abstract] OR "acquired immune deficiency syndrome"[Title/Abstract] ")
Limits: restricted to Randomized Controlled Trial, Controlled Clinical Trial, Clinical Trial, pragmatic Controlled Trial Congress, full text, English

Article title, abstract, keyword; ("psychological intervention" OR "mental intervention") AND (HIV OR "Human immunodeficiency virus") OR ("AIDS
Scopus OR "acquired immune deficiency syndrome")
Limits; nursing, psychology, social science, article, English, open access

Title/abstract, keyword: ("psychological intervention" OR "mental intervention") AND nurse AND ("("HIV" OR "AIDS" OR "Human immunodeficiency
Cochran virus" OR "acquired immune deficiency syndrome")
Limited; trials

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Davoudi et al

Table 2. Characteristics of included studies

Type of intervention in the experimental

Total group
Author (year), Type of intervention in the
sample Finding
Country Duration of control group
size Details
intervention
Blank et al16 Providing counseling and
(2011), 238 coordination of home and 12 months Routine care Significant reduction in viral load
USA mental health services
• Moderate to excellent changes in CD4 + T cell
Blank et al17 Home care services and
and viral load
(2014), 238 coordination between 12 months Routine care
• Improving the quality of life in the physical
USA services
and mental dimension
• Improve adherence to treatment
Virtual training and follow-
• Increase self-efficacy
up (motivational skills, 8 weeks In-person counseling
• Reducing stress
Côté et al18 (2015), emotion recognition, and (4 sessions (providing a list of drug-
179 • Increasing positive attitude
Canada management skills, problem of 20-30 related websites and side
• Average increase in the level of social support
solving, and communication minutes) effects)
• Reducing the discomfort associated with the
with others)
symptoms of the disease
• Reducing the number of depression
Symptom management
Eller et al19 (2013), A 30-minute Nutrition and supportive symptoms, severity and its effects
222 training with practical
South Africa session care training • Positive change in the use of self-care and self-
training
management strategies
Hanrahan et al20 An advanced nursing care • Improvement of symptoms of depression,
(2011) model for face-to-face and mental problems
238 12 months Routine care
United States telephone case management • Improving the quality of life related to health
American at home in the physical dimension
• Reducing risky behaviors
Holstad et al21 Training sessions (Nutrition
Motivational group • Increasing the use of protective equipment
(2011), 203 8 sessions and stress control and
interview during sex
USA health complications)
• Better adherence to treatment
• Reduction of pain (in the dimension of ability
to share feelings and feeling valuable in life,
feeling relaxed)
• Reducing psychological complications
Lowther et al22 Palliative care intervention 6 sessions • Reduce worries
(2015), 120 including physical, over 4 Routine care • Enhancing the family's ability to plan for the
Africa emotional and spiritual months future
• Increasing the quality of life in the mental
dimension
• Increasing the quality of life in the physical
dimension
four Enhanced Usual Care
sessions based on the • Reduction of alcohol use disorder recognition
Madhombiro 23
Motivational Interviewing
8 to 10 alcohol treatment module test score
(2020), 235 blended with brief Cognitive
sessions from the World Health • Decreased viral load
Africa Behavioral Therapy
Organization MH GAP • Improving quality of life and performance
intervention guide)
• Decreased pain intensity
Educational intervention • Better pain management
Nkhoma et al24 includes face-to-face • Reducing pain interference with daily life.
(2015), training, pamphlet A 30-minute Pain medication control • Increase patient and family knowledge about
182
Southeastern presentation, instruction session training pain management
Africa booklet, and telephone • Increasing the motivation of the family to
follow-up manage the patient's pain
• Improving the quality of life
Wang et al25 • Increased adherence to treatment
Home visit and telephone
(2010), 116 8 months Routine care • Improved quality of life
contact by a nurse
China • Reduced symptoms of depression

Eight RCT articles, one semi-experimental and one location, interventional measures and study findings.
cluster randomized clinical trial (cRCT) study were found. Initially, several sessions were held to match the rating of
Four interventions were implemented in the patients’ the two evaluators. Before the study, the kappa coefficient
home and five interventions in health care settings. of agreement between the two evaluators was calculated
Cochrane data extraction form was used. The two which was 0.87. In the case of a difference of opinion
authors independently extracted the article information between the two evaluators, the opinion of third evaluator
and agreed upon it after discussion. This form included was used. Two reviewers independently evaluated
the author’s first name, year of publication, research the quality of the articles and analyzed abstracts and

96 Journal of Caring Sciences, 2023, Volume 12, Issue 2

 Psychological interventions for HIV/AIDS

Identification
Articles obtained from initial Articles obtained from initial search
search of databases (n = 192) in other sources of information (n=1)

Screenin
g

Records after duplicates removed (n= 176)

Records excluded based on

Eligibility

title and abstracts (n= 132)

Full text studies assessed for eligibility (n = 44)
Full text study excluded (n = 34) with reasons:
No full text of articles = 2
Unknown Intervention provider= 8
Included

Care team as Intervention provider= 3

Studies included in qualitative synthesis (n = 10) The intervention provider is not a nurse = 21

Figure 1. Preferred reporting items systemic review (PRISMA) flowchart

limitations of the studies. Before reviewing the articles, the services, symptom and side effects management services,
names of the authors and journals were eliminated. The palliative care services, case management, and motivational
article information was summarized using the modified interviewing with cognitive behavioral therapy.
JADAD tool. This checklist includes 8 questions assessing The patients were followed-up by phone or in-person.
different sections of the article. A score of 0 to 4 was The duration of Interventions varied from one training
considered as weak study, 4 to 6 as moderate, and scores session to 12 months. The duration of follow-up varied
of ≥ 6 as strong study26 (Table 3). Then, a summary of the from 8 weeks to 24 months. In six studies, the effects of
articles was presented in multidimensional tables. Also, the designed psychological intervention were compared
the mean score and P value were evaluated and compared. with routine care group.16,17,20,22,23,25 in other studies, the
effects of two designed interventions were compared
Results compared.18,19,21,24 The study units in 9 studies were male
Since psychological support for patients with AIDS/ and female patients with AIDS/HIV and in one study only
HIV includes any support provided to help HIV/AIDS women with AIDS/HIV were included. Interventions
patients improve psychological, cognitive, emotional, and were performed on patients with different ages and stages
behavioral well-being, the results of the studies which of the disease and different underlying diseases.23
performed the interventions according to this definition Accordingly, 3 studies reported a decrease in the
are explained in this section. Accordingly, a total of 1975 severity of depression and its symptoms after the
participants started interventions and 1687 included in intervention.19,20,25 Also, 3 studies emphasized the
the analyses at the final follow-up, however, the numbers improvement of patients’ adherence to the treatment
were sometimes unclearly reported. Participants included regimen and the use of antiviral medications after the
adults of any age diagnosed with HIV/AIDS. One study intervention,18,21,25 but in one of these three studies (semi-
involved only women.21 The sample size varied from 11625 experimental study with moderate tool score),18 despite
to 23816,17,20 participants. Women involved 41.77% of the the improvement in adherence to treatment, there was
total population. The mean age of the participants was no significant difference between the intervention and
42/49 years. Also, 40% of these studies were conducted in the control groups. One article suggested that conducting
America, 40% in Africa, 10% in Europe and 10% in Asia. a group motivational interview and a problem-solving
The articles were evaluated by the modified Jadad scale. program led to a reduction in risky behaviors in women
The assessment included the effect of randomization, and increased use of contraceptive methods during sexual
appropriate randomization, blind study, appropriate intercourse.21 Blank et al also found that home-based care
blinding, inclusion and exclusion criteria, adverse programs, counseling on medical and psychological issues
complications, and statistical analysis.26 Of the 10 studies and effective coordination between health care providers
extracted, 1 was a quasi-experimental study, 8 were reduce the viral load and increase the CD4 + T cell count.16,17
randomized clinical trials, and 1 was cluster randomized Concerning the effectiveness of nursing interventions on
clinical trial. Also, 40% (n = 4) had moderate quality and patients’ pain and managing it, some studies showed that
60% (n = 6) had high quality (Table 3). pain intensity can be reduced by receiving palliative care
Nurses’ interventions in the above mentioned studies and face-to-face and phone-based patient education.22,24
included virtual intervention and training of emotional Moreover, the quality of life, especially in the mental and
management skills, communication skills, motivational physical dimensions, significantly increased after the
and problem-solving skills, home care and counseling quantitative and qualitative improvement of the nurse’s

Journal of Caring Sciences, 2023, Volume 12, Issue 2 97

 Davoudi et al

interaction with the patient at home.17,20,25A study also

Quality
level
showed that nurses’ use of motivational interviews along

M
H

H
with cognitive behavioral therapy can reduce the alcohol
use disorder recognition test score in patients with AIDS/
points
Total

7.5

7.5

5.5

6.5

5.5
4

6
HIV who consume alcohol even after six months. Also,
this supportive intervention can improve the viral load,
statistical analysis
Reference to the

quality of life and performance of these patients.23

No
0

In addition to the main results, some studies reported

method

secondary outcomes. Accordingly, providing patient

Yes

education (motivational skills, recognizing emotional and

1

*
management skills, problem-solving, and communicating
& unwanted side effects
method of investigating

with others) and virtual follow-up can improve patients’

No 0
Reference to the

*
self-efficacy and reduce perceived stress18,19,22,24; this
intervention increases perceived social support and
reduce the incidence of complications associated with the
Yes

disease. Also, it improves a positive attitude and reduces

1

* anxiety.18 Face-to-face training and providing pamphlets

and educational booklets to the patient and family, as
exclusion criteria

No
inclusion and

well as telephone follow-up make the patient’s pain less

Refer to the

interfering with daily life and increase patient and family

knowledge and motivation for pain management.24 Also,
Yes
1

providing patients with palliative care compared to routine

care makes them less likely to experience psychological
interruptions and
Refers to trial

No

distress, reduces their anxiety, increases family capacity

0

*
crashes

for future planning, and improves their quality of life.22

Theoretical and practical training in the management of
Yes
1

disease symptom makes patients use positive self-care

and self-management strategies to improve their mental
mentioned 0
Blinding (single blind = 0.5

health.19
Not

*
double blind = 1)

Discussion
Given the significant impact of psychological health
No
-1

conditions on physical health, medical care, quality of life,

and risk of HIV transmission, this study was conducted
Yes

0.5

0.5

0.5

0.5

0.5
1

to review and summarize the psychological interventions

performed by nurses on patients with AIDS/HIV. To
investigation

No
0

achieve this goal, eight RCTs, one semi-experimental, and

A blind

one cRCT study were reviewed and evaluated. The results

Yes
1

of this systematic review showed that interventions such

*

as virtual or face-to-face educational programs, written

mentioned 0

information resources, palliative care, motivational

Proper randomization

Not
Table 3. Evaluating and scoring the quality of reviewed articles

interviewing, case management, motivational interviewing

with cognitive-behavioral therapy, and home care
with face-to-face or telephone follow-up can positively
No
-1

affect the quality of life, manage disease and symptoms,

increase patients’ adherence to treatment, improve their
Yes
1

mental and functional health, and reduce patients’ risky

Quality level: H = High; M = Moderate.
being random

No

behaviors. These psychological interventions can be done

Pointing to

by nurses independently because they have the skills to

Yes

deliver them. This is an important point because it is

1

associated with improving patient-related outcomes and

23

achieving health policy goals, and development of nurses’

Madhombiro et al
Hanrahan et al20

24

professional roles.
22
Holstad et al21

Nkhoma et al
Lowther et al

Wang et al25
Blank et al16

Blank et al17
18

19

Since this study is the first study to answer the research

Côté et al

Eller et al
Author

question “what are nursing psychological interventions in

patients with AIDS/HIV and what are the consequences?”,

98 Journal of Caring Sciences, 2023, Volume 12, Issue 2

 Psychological interventions for HIV/AIDS

therefore, the findings of other similar studies were used interventions along with medical treatments play an
to compare the results: important role for patients to manage pain.36 The benefits
The results of the Borgmann and Schmidt showed that of using psychological approaches include increasing pain
psychological interventions improved the quality of life self-control, improving pain management, reducing pain-
of men with prostate cancer. They found that the patients related disability, and reducing emotional stress through
who participated in psychological interventions had a self-monitoring, and behavioral and cognitive therapy.
higher quality of life at the end of the interventions. This Implementing these interventions can help patients more
improvement was significant in the physical dimension, control pain. Also, the skills trained through psychological
but there was no evidence to support the significant effect interventions enable patients to actively manage their
of the interventions in the psychological dimension.27 disease and provide valuable skills that patients can apply in
Anderson and Ozakinci in a review study examined the their life.37 However, Ziehm et al in their systematic review
impact of psychological interventions on the quality of stated that psychological interventions didn’t decrease the
life of patients with chronic conditions; they reported the pain of patients undergoing open-heart surgery.38
significant effect of such interventions on the quality of Psychological interventions can also affect different
life.28 However, the results of a systematic review study by aspects of psychological health in patients with AIDS/HIV.
Timmer et al contradict the present study. They evaluated In addition to physical problems such as pain and lack of
the impact of psychological interventions on patients energy, psychological health problems such as depression
with inflammatory bowel disease, and reported that of and anxiety are also common among patients with AIDS/
the 21 clinical trials reviewed, there was no evidence to HIV.39 The prevalence of mood disorders or depressive
support the effectiveness of psychiatric interventions on symptoms is approximately 33% and the prevalence of
quality of life in adult patients.29 In the study of MacKenzie anxiety is about 20%.40 Thus, psychological interventions
et al there was no evidence to support the effectiveness appear to be associated with improved depression,
of psychological interventions on the quality of life of anxiety, and distress. Consistent with this finding, a
patients undergoing strabismus surgery.30 review study showed that psychological interventions
In the present study, the impact of psychological leads to a short, mid, and long-term reduction in the
interventions on high-risk behaviors of patients with severity of depression in diabetic patients.41 Ziehm et
AIDS/HIV was reported in a moderate-quality study. Risky al also reported that psychological interventions can
sexual behaviors appear to be related to the psychological reduce the psychological stress experienced in patients
health of patients with AIDS/HIV. One study found that undergoing open-heart surgery.38 In contrast to the
women with negative emotions were not able to cope findings of the present study, the results of a systematic
with stress due to the desire to use condoms in sexual review did not confirm the effectiveness of psychological
intercourse. There was also a significant relationship interventions on the improvement of psychological health
between hopelessness and loneliness and sexual risk in of patients with sickle cell anemia.42 Also, Natale et al
homosexual men.31 Another study which examined the .didn’t confirm the impact of psychological interventions
relationship between depression and condom use among on major depression in hemodialysis patients.43 Fisher
278 Chinese women found that 62% of participants had et al also found no significant difference between the
severe depression and were less likely to use condoms psychological intervention group and the usual care group
consistently.32 These results emphasize that psychological in anxiety and depression among children with chronic
interventions may reduce the risk of sexual behaviors and recurrent pain.44
and thus decrease HIV transmission. Meader et al also The efficacy of psychological interventions on
reported that women with drug abuse change their high- laboratory markers of patients with AIDS/HIV was also
risk behaviors, such as sexual and injective behaviors, if seen in two studies. They reported that providing medical
they receive psychological interventions. However, there and home care services to patients results in reduced
was no significant difference between women receiving viral load and improved CD4 + T cell. Since psychological
psychological intervention and those receiving routine factors (such as depressive symptoms and stress) affect
care.33 Carvalho et al also reported the limited effect of immune function such as decreasing CD4 + T cell
behavioral interventions on condom use in women with and increasing viral load,45 therefore, psychological
HIV.34 However, given that only one study examined high- interventions with a positive impact on depression and
risk behaviors in women, no definite conclusions can be anxiety in these patients may be influenced by laboratory
made on the impact of psychological interventions to results and immune function. Also, since psychological
increase protected sex behaviors among patients. interventions lead to increased adherence to treatment,
Kisely et al in a study with moderate quality found improvements in laboratory markers can be considered
that psychological intervention, especially those with the one of the therapeutic consequences of adherence. Locher
cognitive-behavioral approach, will be effective on heart et al also agree with the present findings regarding the
pain in people without coronary artery disease.35 Another impact of psychological interventions on viral load and
study with good quality reported that psychological adherence to treatment.46 Moreover, Chew et al also found

Journal of Caring Sciences, 2023, Volume 12, Issue 2 99

Davoudi et al

that psychological interventions compared to routine Research Highlights

care may lead to improved HbA1C outcomes in diabetic
patients. Since the reviewed articles have low-quality What is the current knowledge?
levels, they emphasized that stronger evidence is needed • HIV/AIDS patients experience significant
to confirm the impact of psychological interventions on medically and psychologically suffering
HbA1C levels.47 Madhombiro et al also reported similar • One of the traditional responsibilities and roles of
results between the groups receiving the psychological nurses is psychological support for these patients.
intervention and routine care in terms of viral load and • We do not know what interventions nurses
CD4 + T cell. Their finding contradicts the results of the can take directly and independently to provide
present study.48 psychological support to these patients and what
According to the results of the present study, are the consequences.
psychological interventions also increase adherence to What is new here?
treatment. Adherence to treatment in patients with AIDS/ • Virtual and face-to-face training programs, written
HIV is important because it improves health and well-being information resources, palliative care, motivational
and reduces the risk of infection transmission. Failure interviewing, case management, visits and home
adherence to treatment is associated with psychological care services along with face-to-face and telephone
health problems and stressors, such as depression49 and follow-up can be done directly by nurses.
anxiety.50 The results of a meta-analysis study showed • Psychological interventions have a significant
that psychological factors are strongly associated with positive effect on quality of life and management
adherence to treatment.51 People with psychological of high-risk behaviors, disease management,
health problems due to cognitive and behavioral problems and adherence to treatment, immune system
such as fatigue, hopelessness, decreased motivation function and psychological health in patients with
and concentration may have more difficulty in seeking HIV/AIDS.
treatment.52 Psychological interventions primarily focus
on psychological or social factors rather than just on
medical factors. Therefore, psychological therapies may lead to the achievement of health goals in the physical,
be a priority for adherence to treatment. Goldbeck et psychological, behavioral and laboratory fields. However,
al also emphasize the positive effect of psychological the clinical impact of these results is unclear because this
interventions on diet in children with cystic fibrosis.53 systematic review only summarized and reported results
These differences in different studies can be attributed qualitatively. Therefore, it is not possible to measure
to differences in the power and quality of studies, and the intensity of the interventions from this systematic
intervention protocols (provider, skill level, content, style, review. So, it is suggested to conduct meta-analysis studies
duration of intervention, etc.), and target groups. to determine the intensity of the effect of each of these
One of the strengths of this study is that it was conducted interventions on specific aspects of the problems of
comprehensively because several databases and reviewed patients with AIDS/HIV.
articles published from 2009 to 2022 were searched. Also,
to the best of our knowledge, this systematic review is Acknowledgments
The authors would like to thank all the authors of the articles used
one of the first records to document the psychological in this review study. Also, the central library authorities of Mashhad
interventions directly provided by nurses to patients with University of Medical Sciences is appreciated for providing access
AIDS/HIV. So it can be a guideline for future research. to related studies from various databases.
Limitations of this review study include lack of access
to full-text articles despite contact with authors and lack Authors’ Contribution
Conceptualization: Malihe Davoudi, Abbas Heydari, Zahra Sadat
of knowledge of authors in non-English languages. The
Manzari.
results of this study may also be influenced by the bias Data curation: Malihe Davoudi.
in the studies and a considerable degree of heterogeneity Formal analysis: Malihe Davoudi, Zahra Sadat Manzari.
between them. In general, given the limited literature Funding acquisition: Abbas Heydari.
in this area, it is needed for further clinical trials on Methodology: Malihe Davoudi, Abbas Heydari, Zahra Sadat
Manzari.
the research question. Meta-analysis studies are also
Project administration: Abbas Heydari.
recommended to gain a clear understanding of the results. Supervision: Abbas Heydari, Zahra Sadat Manzari.
Writing–original draft: Malihe Davoudi.
Conclusions Writing–review & editing: Abbas Heydari, Zahra Sadat Manzari.
There is evidence that nurses are able to independently
Competing Interests
design and implement effective psychological interventions
There is no conflict of interest.
for patients with AIDS/HIV. This is a fundamental step for
developing the professional roles of nurses and improving Data Availability
the care of AIDS/HIV patients. These interventions All data generated or analyzed during this study are included in this

100 Journal of Caring Sciences, 2023, Volume 12, Issue 2

 Psychological interventions for HIV/AIDS

published article. et al. Updated guidance for trusted systematic reviews: a new
edition of the Cochrane Handbook for Systematic Reviews
Ethical Approval of Interventions. Cochrane Database Syst Rev. 2019; 10:
Ethical considerations have been observed in all stages of research, ED000142. doi: 10.1002/14651858.ed000142
including the study and collection of data, their documentation, 15. Moher D, Liberati A, Tetzlaff J, Altman DG. Preferred reporting
analysis, and publication. items for systematic reviews and meta-analyses: the PRISMA
statement. PLoS Med. 2009; 6(7): e1000097. doi: 10.1371/
Funding journal.pmed.1000097
The financial support of this study was provided by the Research 16. Blank MB, Hanrahan NP, Fishbein M, Wu ES, Tennille JA, Ten
and Technology Vice-Chancellor of Mashhad University of Medical Have TR, et al. A randomized trial of a nursing intervention for
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