Acceptance and Compassion-Based Group Therapy to Reduce HIV Stigma

• This is the first pilot study to explore the integration of ACT and CFT.
• ACT promotes flexibility in response to societal stigma.
• This is the first case study that describes ACT for men living with HIV.
• More research is needed to explore ACT for HIV-related stigma reduction.

Interventions that target the burden of HIV-related stigma among gay and bisexual men with HIV could yield a broad array of benefits to HIV-positive individuals. In particular, recent research suggests that reducing HIV-related stigma might increase contact with medical professionals, adherence to medication, disclosure to sexual partners, and enhance the ability of persons with HIV to build necessary support networks. In this clinical pilot, we examined the feasibility, acceptability, and usefulness of delivering an HIV-related stigma-reducing group intervention in a community mental health setting to gay and bisexual men living with HIV who are currently connected with care but reporting ongoing difficulties due to HIV-related stigma. The basis of this intervention, acceptance and commitment therapy (ACT), has been found to be effective in reducing the experience of self-stigma among persons with substance abuse histories, and a recent pilot suggests it is helpful for gay and lesbian persons experiencing internalized homophobia. Along with ACT, we have incorporated ideas and exercises from compassion-focused therapy (CFT), an intervention designed to increase compassion while decreasing shame, an affective state close to self-stigma. We hypothesized that this integrated approach would be effective for those experiencing HIV-related stigma. Eight clients currently receiving mental health treatment at the UCSF Alliance Health Project (AHP) Services Center were recruited via clinician referral for an eight-session group, and five completed the group. Follow-up measures of psychological flexibility and HIV-related stigma were completed by three participants, whose data is presented here.