Technology-Delivered Psychotherapeutic Interventions in Improving Depressive Symptoms Among People with HIV/AIDS: A Systematic Review and Meta-analysis of Randomized Controlled Trials

With the increasing popularity of advanced technology, technology-delivered psychotherapeutic interventions (TPIs) may play a promising role in improving depressive symptoms among PLWHA. However, its effectiveness remains unclear. We aimed to synthesize the evidence of the effectiveness of TPIs in improving depressive symptoms of PLWHA using a meta-analytic approach. Seven databases were systematically searched for randomized controlled trials (RCTs) from the inception until August 14, 2018. Random-effects meta-analysis was adopted to assess effect size. Cochran’s Q test and I2 were used to investigate the problem of heterogeneity. Sensitivity, subgroup analyses and meta-regression were performed. Of the 43,048 records identified, 14 RCTs were included. The meta-analysis revealed a small effect on reducing depressive symptom scores (d = 0.23, 95% CI - 0.39 to - 0.06) after TPIs.

Random-effects meta-regression showed that publication year was a significant moderator (p = 0.013), whereby the latest trials had larger effect size in reducing the depressive symptoms than earlier trials. Our review suggested a possible future approach of utilizing TPIs by means of mobile applications and internet-based interventions for PLWHA to reduce their depressive symptoms. This review highlighted the essential key features in designing future TPIs. The overall low-quality evidence suggested the need to conduct further high-quality.