Psychocorrective Support of Hiv-Infected People at the Stage of Return to Treatment

The article presents the experience of developing and implementing a 16-week psychocorrective program aimed at psychological support for people living with HIV and resuming antiretroviral therapy (ART) after a long break. The program integrates the methodological foundations of cognitive behavioral therapy (CBT) and dialectical behavioral therapy (DBT), which allows comprehensive work with a wide range of psychological difficulties typical of this group of patients: guilt, internal stigmatization, emotional dysregulation, low commitment to treatment and a lack of adaptive coping strategies. The study involved 60 people who were treated in a specialized medical institution and divided into an experimental group of 34 patients (17 women and 17 men) aged 37.4 ± 10.8 years and a control group of 26 patients (21 women and 5 men) aged 38.7 ± 8.6 years. The psychocorrective program was based on theoretical analysis and experimental data obtained. To assess the dynamics of the psychological state before and after the implementation of the program, standardized psychodiagnostic methods were used: Hospital Anxiety and Depression Scale (HADS, A. Zigmond and R. Snaith, adapted by M.Y. Drobizhev); aggressiveness test (L.G. Pochebut Questionnaire); methods of coping behavior (Ways of Coping Questionnaire – WCQ, R. Lazarus, S. Folkman, adapted by the V.M. Bekhterev Institute); WHO short questionnaire for assessing the quality of life (QUALITY OF LIFE (WHOQOL) – BREF, adapted by the V.M. Bekhterev Institute); the scale of General Self-Effecacy (GSE, R. Schwarzer, M. Jerusalem, adapted by V.G. Romek); the Morisky-Green compliance scale (Medicine Adhesion report scale, MARS). According to the results of 16 weeks of psychocorrective support, statistically significant changes were recorded: the level of anxiety decreased, the indicators of depression. The level of overall self-efficacy increased, which indicates a strengthening of participants' confidence in their own abilities and ability to cope with difficulties. The analysis of coping strategies revealed a shift of dominant strategies towards adaptive ones – in particular, the use of strategies such as "seeking social support" and "problem solving" increased. In addition, there was a significant improvement in the subjective quality of life. The results obtained confirm the high efficiency and clinical expediency of using the integrative psychotherapeutic approach CBT/DBT in working with HIV-infected patients experiencing a crisis of adherence to therapy. The presented program can be recommended for implementation in the practice of medical and psychological counseling services working with this category of patients.