An exploratory study of ethnicity and psychotherapy outcome among HIV-positive patients with depressive symptoms

Few data address the relationship between ethnic status and psychotherapy outcome. This study reports data from a four-cell, 16-week controlled clinical trial for HIV-positive patients with depressive symptoms. Patients (N = 101) were randomized to 16 weeks of treatment with interpersonal psychotherapy, cognitive-behavioral therapy (CBT), supportive psychotherapy, or imipramine plus supportive psychotherapy. Analyses found an ethnicity-by-treatment interaction wherein African-American subjects (n = 18) assigned to CBT (n = 4) had significantly poorer outcomes than other patients. This is the first study to uncover an ethnicity-by-specific psychotherapy interaction. Its meaning is unclear. This charged topic requires cautious treatment, particularly given the small sample size in this study, but warrants further research.