***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Objective This r and omized clinical trial was design ed to compare the effects of a theory-based coping effectiveness training ( CET ) intervention with an active informational control ( HIV-Info ) condition and a waiting-list control ( WLC ) condition on psychological distress and positive mood in HIV-seropositive gay men . Material s and Methods The authors recruited 149 self-identified gay or bisexual men who were 21 to 60 years of age , reported depressed mood , and had CD4 levels of 200 to 700 cells/mm3 .  CET and HIV-Info participants attended 10 90-minute group sessions during the 3-month intervention phase and six maintenance sessions over the remainder of the year . Participants were assessed at baseline and at 3 , 6 , and 12 months . Data were collected 1992 to 1994 , before the introduction of HAART . Analyses were based on the 128 participants who completed the 3-month assessment . Results After the 3-month intervention phase , when compared with HIV-Info , CET participants showed significantly greater decreases in perceived stress and burnout , and regression analyses indicated that significant increases in coping self-efficacy mediated the improvements in perceived stress and burnout . Compared with WLC , CET participants also showed significantly greater decreases in anxiety , and regression analyses indicated that significant increases in positive states of mind mediated the improvements in anxiety . Significant treatment group differences for positive morale were maintained at 6 and 12 months . In addition , optimism continued to increase in the CET and HIV-Info treatment groups during the maintenance phase . Conclusions CET can be an effective strategy for managing psychological distress and improving positive psychological states in patients confronting chronic illness Mounting evidence suggests that smokers living with HIV/AIDS have a significantly increased risk of numerous adverse health outcomes ( both AIDS- and non-AIDS-related ) compared with HIV-positive nonsmokers . Therefore , efforts to design and implement effective cessation programs for this ever-growing special population are warranted . The present study assessed the effects of a cell phone intervention ( CPI ) on hypothesized mediators ( i.e. , changes in depression , anxiety , social support , and self-efficacy ) demonstrated to influence cessation outcomes in other population s. Ninety-five participants from an inner-city AIDS clinic were r and omized to receive either the CPI or recommended st and ard of care ( RSOC ) smoking cessation treatment . Participants r and omized to the RSOC group ( n=47 ) received brief advice to quit , a 10-week supply of nicotine patches , and self-help material s. Participants r and omized to the CPI group ( n=48 ) received RSOC components plus a series of eight proactive counseling sessions delivered via cell phones . A series of regression analyses ( linear and logistic ) was used to assess the relationships between treatment group , the hypothesized mediators , and biochemically confirmed smoking cessation outcomes . Results indicated that the CPI group experienced greater reductions in anxiety and depression , and increases in self-efficacy compared with the RSOC group . Further , changes in depression , anxiety , and self-efficacy weakened the association between treatment group and cessation outcome . The mediator hypothesis , however , for social support was rejected , as the difference score was not significantly associated with treatment group . These results suggest that the efficacy of the CPI is at least partially mediated by its ability to decrease symptoms of distress while increasing self-efficacy We wished to determine the short-term safety and efficacy of a Chinese medicinal herb preparation in treating symptoms of human immunodeficiency virus ( HIV ) infection in a 12-week r and omized , double-blind , placebo-controlled clinical trial in a University-affiliated acquired immunodeficiency syndrome ( AIDS ) clinic at a public general hospital . Thirty adults with symptomatic HIV infection , no previous AIDS-defining diagnosis , and CD4 + counts of 0.200 - 0.499 x 10(9)/L ( 200 - 499/mm3 ) received 28 tablets each day of either a st and ardized oral preparation of 31 Chinese herbs or a cellulose placebo . Primary outcome measures were changes in life satisfaction , perceived health , and number and severity of symptoms . Other outcomes included adherence , and changes in weight , CD4 + count , depression , anxiety , physical and social function , and mental health . Two placebo- and no herb-treated subjects had mild adverse events ( AE ) . Subjects on both arms reported taking 94 % of prescribed tablets . No differences between treatment groups reached the p < 0.05 level . Life satisfaction improved in herb-treated [ + 0.86 , 95 % confidence interval ( CI ) : + 0.29 , + 1.43 ] but not in placebo-treated subjects ( + 0.20 , 95 % CI -0.35 , + 0.75 ) . Number of symptoms was reduced in subjects receiving herbs ( -2.2 , 95 % CI -4.1 , -0.3 ) but not in those receiving placebo ( -0.3 , 95 % CI -3.2 , + 2.7 ) . There were trends toward greater improvements among herb-treated subjects on all symptom subscales except dermatologic . Believing that one was receiving herbs was strongly associated with reporting that the treatment had helped ( p < 0.005 ) , but not with changes in life satisfaction or symptoms . There were improvements in life satisfaction and symptoms among subjects receiving the herbal therapy . Whether Chinese herbs are effective in the management of symptomatic HIV infection can be adequately addressed only by larger trials of longer duration Background People who are HIV-positive now live longer when they have contracted AIDS , and nursing interventions can help improve their quality of life . Objectives To test the effects of an intervention based on developing cognitive coping skills as compared to one focused on facilitating the expression of emotions . Both interventions were intended to help regulate emotional response to an exacerbation of HIV-related symptoms . Method In a r and omized , controlled trial , 90 hospitalized HIV-positive men were r and omly assigned to one of three groups : cognitive , expression , or control . The intervention was administered on three consecutive days in 20–30 minute sessions . Preintervention and postintervention data were gathered on mood , distress , and anxiety . Results Both interventions produced a beneficial effect on negative affect ( cognitive group p = .002 , expression group p = .011 ) , and immediately following the first daily session ( p = .001 ) . No change in positive affect was produced by either intervention . Paired t tests indicated a decrease in distress ( p = .039 ) , specifically , of intrusive ideation ( p = .03 ) , for the cognitive group , which also experienced a decrease in anxiety from immediately before to immediately after each session . Conversely , the expression group experienced an increase in anxiety ( p = .018 ) . Discussion The cognitive coping skills nursing intervention was effective in helping to regulate HIV-positive persons ’ emotional responses to advanced disease . This nursing intervention is feasible for use by skilled practitioners providing daily care We examined the efficacy of a psycho-spiritual intervention of mantram repetition -- a word or phrase with spiritual associations repeated silently throughout the day -- on psychological distress ( intrusive thoughts , stress , anxiety , anger , depression ) , quality of life enjoyment and satisfaction , and existential spiritual well-being  in HIV-infected adults . Using a 2-group by 4-time repeated measures design , 93 participants were r and omly assigned to mantram ( n = 46 ) or attention control group ( n = 47 ) . Over time , the mantram group improved significantly more than the control group in reducing trait-anger and increasing spiritual faith and spiritual connectedness . Actual mantram practice measured by wrist counters was inversely associated with non-HIV related intrusive thoughts and positively associated with quality of life , total existential spiritual well-being , meaning/peace , and spiritual faith . Intent-to-treat findings suggest that a mantram group intervention and actual mantram practice each make unique contributions for managing psychological distress and enhancing existential spiritual well-being in adults living with HIV/AIDS Objective : To determine the impact of nutritional ( selenium ) chemo-prevention on levels of psychological burden ( anxiety , depression , and mood state ) in HIV/AIDS . Method : A r and omized , double-blind , placebo-controlled selenium therapy ( 200 μ/day ) trial was conducted in HIV+ drug users from 1998–2000 . Psychosocial measures ( STAI-State and Trait anxiety , BDI-depression , and POMS- mood state ) , clinical status ( CD4 cell count , viral load ) , and plasma selenium levels were determined at baseline and compared with measurements obtained at the 12-month evaluation in 63 participants ( 32 men , 31 women ) . Results : The majority of the study participants reported elevated levels of both State ( 68 % ) and Trait ( 70 % ) anxiety . Approximately 25 % reported overall mood distress ( POMS > 60 ) and moderate depression ( BDI > 20 ) . Psychological burden was not influenced by current drug use , antiretroviral treatment , or viral load . At the 12-month evaluation , participants who received selenium reported increased vigor ( p = 0.004 ) and had less anxiety ( State , p = 0.05 and Trait , p = 0.02 ) , compared to the placebo-treated individuals . No apparent selenium-related affect on depression or distress was observed . The risk for state anxiety was almost four times higher , and nearly nine times greater for trait anxiety in the placebo-treated group , controlling for antiretroviral therapy , CD4 cell decline ( > 50 cells ) and years of education . Conclusions : Selenium therapy may be a beneficial treatment to decrease anxiety in HIV+ drug users who exhibit a high prevalence of psychological burden Psychological effects of participation in Protocol 019 , a zidovudine placebo-controlled clinical trial , were investigated . Forty-six Protocol 019 subjects and 27 control asymptomatic human immunodeficiency virus-seropositive subjects were assessed at entry , 2 months , 6 months , and after trial modification . At baseline there were no psychological differences . Most Protocol 019 and control subjects were depressed on at least one psychological measure ; fewer were anxious . Both groups had improvement over time . By 6 months , Protocol 019 subjects had decreased Beck Depression Inventory ( BDI ) scores , state anxiety , stress reaction , and symptoms of depression and anxiety . Controls had decreased scores on only the BDI . Over time , the percentage meeting modified DSM III-R criteria for anxiety decreased in both groups and the proportion of Protocol 019 subjects meeting DSM III-R depression criteria decreased . After protocol modification , study subjects were less depressed and distressed than controls . Protocol 019 subjects reduced depression symptoms but controls did not . Clinical trial participation was not deleterious and may have yielded some relative psychological benefit & NA ; We investigated the effects of two behavioral interventions —aerobic exercise and cognitive behavioral stress management (CBSM)—on Epstein‐Barr virus viral capsid antigen ( EBV‐VCA ) and human herpesvirus type‐6 ( HHV‐6 ) antibody modulation in 65 asymptomatic gay men measured at several time points in the 5 weeks preceding and following notification of their human immunodeficiency virus‐type 1 ( HIV‐1 ) serostatus . After accounting for potential immunomodulatory confounds , we found that HIV‐1 seropositive men had higher EBV‐VCA antibody titers than those diagnosed as seronegative at every time point during the study ; however , no significant differences were found with respect to HHV‐6 . Among HIV‐1 seropositive and seronegative subjects , respectively , those r and omized to either behavioral intervention had significant decreases in both EBV‐VCA and HHV‐6 antibody titers over the course of the intervention as compared with assessment ‐only controls ( of HIV‐1 seropositive and seronegative status ) whose antibody titers did not significantly change and which remained consistently higher than either serostatus‐matched intervention group over subsequent time points , independent of total immunoglobulin G levels and degree of polyclonal B cell activation . In attempting to explain serostatus differences in EBV and HHV‐6 values , it was found that HIV‐1 seropositive men had significantly lower CD4 cells , CD4:CD8 ratio , and blastogenic response to phytohemagglutinin ( PHA ) , as well as significantly higher CD8 cells at baseline . No significant differences were found between the HIV‐1 seropositive and seronegative men with respect to anxiety and depression at baseline . Since the greatest changes in EBV and HHV‐6 occurred between baseline and week 10 , we correlated changes in immune ( CD4 , CD8 , CD4:CD8 ratio , PHA stimulation ) and distress‐related markers ( state depression and anxiety ) with EBV and HHV‐6 change scores over this time period . No significant correlations were found between any of these immune‐ or distress‐related variable and the antibody change scores suggesting that the mechanisms by which EBV and HHV‐6 antibodies are being modulated by these interventions possibly involve other , yet to be determined , immune , neuroendocrine , and /or psychologic variables Objective : To evaluate the safety and efficacy of polyalkylimide gel ( PAIG ) in the treatment of HIV-associated facial lipoatrophy . Design : A r and omized , open-label , single-centre study . Methods : HIV-positive individuals with facial lipoatrophy ( based on physician assessment ) were r and omly assigned to immediate 
    Output:
    
Psychological interventions ( especially cognitive behavioural stress management interventions and cognitive behavioural therapy ) were generally more effective than pharmacological interventions .
Our detailed data suggest that interventions are both effective and available , although further research into enhancing efficacy would be valuable .