Mindfulness meditation training has stress reduction benefits in various patient populations, but its effects on biological markers of HIV-1 progression are unknown. The present study tested the efficacy of an 8-week Mindfulness-based stress reduction (MBSR) meditation program compared to a 1-day control seminar on CD4+ T lymphocyte counts in stressed HIV infected adults. A single-blind randomized controlled triallCD4+ T lymphocytes. Participants in the 1-day control seminar showed declines in CD4+ T lymphocyte counts whereas counts among participants in the 8-week MBSR program were unchanged from baseline to post-intervention (time × treatment condition interaction, p = .02). This effect was independent of antiretroviral (ARV) medication use. Additional analyses indicated that treatment adherence to the mindfulness meditation program, as measured by class attendance, mediated the effects of mindfulness meditation training on buffering CD4+ T lymphocyte declines. These findings provide an initial indication that mindfulness meditation training can buffer CD4+ T lymphocyte declines in HIV-1 infected adults.
Although great advances have been made in antiretroviral (ARV) treatment of HIV-1 infection, there is still variability in treatment outcome (May et al., 2006). Psychological stress may account for some of this variability, as animal and human studies have demonstrated that stress accelerates HIV-1 disease pathogenesis and impairs the biological impact of ARV treatment (for review, see Cohen et al., 2007, Cole et al., 2001 and Ironson et al., 2005). Consistent with this, recent studies indicate that behavioral stress management interventions may improve biological indicators of HIV-1 pathogenesis (Antoni et al., 2006 and Petrie et al., 2004, cf. Crepaz et al., 2008), but it is unknown whether mindfulness meditation impacts HIV-1 progression (Ospina et al., 2007 and Robinson et al., 2003).
The Mindfulness-based stress reduction (MBSR) program (Kabat-Zinn, 1982) is a standardized and manualized 8-week mindfulness meditation training intervention that has been shown to reduce stress and improve self-reported health outcomes in a variety of patient populations (Brown et al., 2007). In the MBSR program, participants practice a series of guided mindfulness meditation exercises in weekly classes and at home daily (e.g., body awareness, mindful stretching, sitting meditation, and mindfulness in daily life practices). It is thought that the MBSR program helps participants bring a more open and receptive awareness to their present moment experiences in daily life, facilitating a greater recognition and regulation of stress (Brown et al., 2007). Currently, few investigations have examined the effects of MBSR on immune outcomes or biological stress pathways, but initial studies in this area indicate that MBSR may have salutary effects on antibody titer response to influenza vaccination (Davidson et al., 2003), cytokine signaling in cancer patients (Carlson et al., 2007 and Carlson et al., 2003), and NK cell numbers and cytotoxic activity in HIV patients (Robinson et al., 2003). Further, some recent evidence suggests that MBSR may reduce total daily salivary cortisol output at follow-up (Carlson et al., 2007), an effect that may be consistent with stress reduction. An initial pilot study of MBSR in HIV-1 indicated that mindfulness meditation training can impact immune system function (Robinson et al., 2003CD4+ T lymphocytes and HIV viral load. Thus, a single blind randomized controlled trial was conducted to test whether an 8-week MBSR program buffers CD4+ T lymphocyte declines in a community sample of HIV-1 infected adults.
