Effectiveness of Mindfulness-Based Cognitive Therapy in Reducing Anxiety among Adolescents Living with HIV in Nairobi, Kenya: A Mixed- Methods Quasi-Experimental Study

Adolescents living with HIV (ALHIV) face considerable psychosocial challenges that increase their vulnerability to anxiety. HIV-related stigma, disclosure concerns, treatment demands, uncertainty regarding future relationships, and fear of social exclusion contribute significantly to psychological distress. Despite advances in antiretroviral therapy (ART), anxiety remains a major challenge affecting treatment adherence, psychosocial adjustment, and quality of life among adolescents living with HIV. Evidence-based psychological interventions tailored to this population remain limited within HIV care settings in Kenya.
Objective: This study evaluated the effectiveness of Mindfulness-Based Cognitive Therapy (MBCT) in reducing anxiety among adolescents living with HIV attending a comprehensive HIV treatment centre in Nairobi County, Kenya.
Methods: The study employed a pragmatic mixed-methods quasi-experimental single-group pretest-posttest design. Fifty-four adolescents aged 13–19 years living with HIV participated in an eight-week MBCT intervention. Anxiety symptoms were measured using the Beck Anxiety Inventory (BAI) before and after participation in the intervention. Quantitative data were analyzed using descriptive statistics, paired-samples t-tests, and analysis of variance (ANOVA), while qualitative data obtained through focus group discussions and semi-structured interviews were analyzed using thematic analysis.
Results: The mean anxiety score decreased from 32.91 at baseline to 18.48 following the intervention. Paired-samples t-test results demonstrated a statistically significant reduction in anxiety symptoms, t(53) = 10.46, p < .001. Qualitative findings revealed improvements in emotional regulation, self-awareness, coping capacity, resilience, and acceptance of HIV status. Participants also reported reduced HIV-related worry, disclosure anxiety, and fear of social rejection.
Conclusion: Mindfulness-Based Cognitive Therapy demonstrated significant effectiveness in reducing anxiety among adolescents living with HIV. The findings suggest that MBCT is a feasible, culturally adaptable, and potentially scalable psychosocial intervention that could be integrated into routine adolescent HIV care services to improve psychological wellbeing.

Mindfulness-Based Cognitive Therapy, Anxiety, Adolescents Living with HIV, Psychological Wellbeing, HIV Care, Kenya, Mental Health

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