The Effect of Cognitive-Behavioral Group Therapy Using Art as a Medium on Depressive Symptoms and HIV Antiretroviral Medication Adherence

  • Panu SahassanonEmail author
  • Kullaya Pisitsungkagarn
  • Nattasuda Taephant


The prevalence of HIV in Thailand continues to increase, especially among men who have sex with other men (MSM). Being stigmatized can result in depression, which can negatively impact antiretroviral medication adherence. This quasi-experimental research study aimed to examine the effects of cognitive-behavioral group therapy using art as a medium on depressive symptoms and medication adherence. Forty-six MSM were assigned (23 × 2) either to a weekly 2-h art-based CBGT group session for a total of 8 weeks or to a no-intervention control group. The experimental group of 23 met in 4 separate small groups. Pre-intervention period analyses indicated no significant differences between the two groups in the key variables examined, together with demographic information including the participants’ ages, education levels, and CD4 (T cells) levels. Measures of depressive symptoms and antiretroviral medication adherence were administered pre- and post-intervention. Using MANOVA, findings suggested that depressive symptom scores among the intervention group were reduced significantly post-treatment (p < .01) and were significantly lower than those of the control group (p < .001). Scores among the experimental group for medication adherence increased significantly pre- to post-treatment (p < .025); however, post-treatment scores were not significantly different between the experimental and control groups. These findings provide initial evidence for the potential effectiveness of art-based CBGT in alleviating depressive symptoms and enhancing antiretroviral medication adherence in MSM with HIV.


Art-based cognitive-behavioral group therapy Depressive symptoms Antiretroviral medication adherence HIV-infection Thailand 



We thank Analisa Avila, ELS, of Edanz Group ( for editing a draft of this manuscript.

Compliance with Ethical Standards

Conflicts of Interest

The authors declare that they have no conflict of interest.

Ethical Approval

This research project was approved by the review committee at the Faculty of Psychology, Chulalongkorn University, and conforms to the provision of the Declaration of the Helsinki whereby informed consent for study participation was obtained and participant anonymity was preserved.


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© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Faculty of PsychologyChulalongkorn UniversityBangkokThailand

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