Carey to study HIV stress, barriers

MICHAEL CAREY is director of the The Centers for Behavioral and Preventive Medicine at The Miriam Hospital in Providence. The center recently was awarded a $146K grant to study whether meditation over a telephone is effective in reducing the effects of HIV. The study will examine how mindfulness might ease anxiety and promote healthier behavior in patients. Miriam is the first hospital to study mindfulness training in this way, with funding from The National Center for Complementary and Integrative Health.

Studies have shown that mindfulness can help lessen anxiety for chronic conditions. Does HIV have special considerations in this realm?

As is true for all chronic diseases, it is important for people living with HIV to receive regular clinical care, take their medications and practice good health behaviors. However, HIV is also unique. Historically, HIV has been highly stigmatized. HIV has also disproportionately affected minorities and people from racial and ethnic minorities who experience unique social disadvantage, including higher poverty rates and discrimination, factors that can lead to additional stress. … Stress takes a profound toll on the body and can exacerbate diseases.

How might such a system work?

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Our research project is designed to address this question. We are working with patients and providers at The Miriam Hospital to devise a practical system for telephone-based coaching. First, we are meeting with patients, providers and advocates in separate focus groups. … We will develop a practical system to connect patients with instructors and earn patients’ trust and confidence in the system. Then, we will develop a phone-delivery system.

Could phone-based mindfulness bridge a cost gap for many people living with HIV? 

Yes. Barriers such as not having access to transportation can keep people from attending clinic-based programs. Phone delivery can also be cost-saving for providers … who need not travel to multiple settings to provide care. Phone-based delivery has the potential to reduce costs for all involved and increase the number of people who can benefit. •

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