Open Access Open Access  Restricted Access Subscription Access

“I am a whole person, not a diagnosis” - A mind-body intervention to improve the mental wellbeing of HIV-infected individuals in Denmark

Lotte Rodkjær, Tinne Laursen, Kirsten Seeberg


Background: Depression is the most common mental health co-morbidity experienced by people living with HIV. We developed an intervention to improve mental health among HIV-infected individuals. The aim was to improve each person’s balance in life, making each person conscious about their own behavior and activating their own resources. The participant worked with their individual process within the group and practised techniques to address fear/stress management. Mental health improved overall and there was a significant decrease in depression. The effect was maintained at 12-months.This study aimed to gain insight into factors that mediated the effects observed.

Methods: Semi-structured interviews were conducted with each participant at the end of the intervention. Digital audio-recordings of the 48 interviews were transcribed and analyzed using thematic analysis.

Results: The following themes were identified as facilitators: Context, Participant, Coach, Intervention approach and Sense of Community. Three themes explained the experienced effect: Transformation, Internalized Stigma Changes and Integrity. We observed that fear no longer controlled the lives of the participants, as the individuals acquired new skills to handle disclosure and internalized stigma. Living with HIV became an integrated part of their life.

Conclusion: Interventions designed to practise and strengthen patients’ insight into the mental and physical contexts of their condition reduces depression, improves mental health and quality of life and should be offered in conjunction with HIV medication and be a fully integrated aspect of HIV care. Thus, treatment calls for a holistic and person-centered approach to patient care, acknowledging that viral suppression is not necessarily the ultimate goal of effective treatment.


Complex intervention, depression, disclosure, HIV, holistic health, mental health, mind-body, patient-centered care, person-centered healthcare

Full Text:



Deeks, S.G., Lewin, S.R. & Havlir, D.V. (2013). The end of AIDS: HIV infection as a chronic disease. Lancet 382, 1525-1533.

Joint United Nations Programme on HIV/AIDS. (2017). Confronting discrimination: Overcoming HIV-related stigma and discrimination in healthcare settings and beyond. Available at:

Danish AIDS Foundation. (2016). Danskerens viden, holdninger og adfærd i forhold til hiv-smittede [Danes’ knowledge, attitudes, and behavior in relation to the HIV-infected]. Available at:

Clark, H.J., Lindner, G., Armistead, L. & Austin, B.J. (2003). Stigma, disclosure, and psychological functioning among HIV-infected and non-infected African-American women. Women’s Health 38, 57-71.

Lee, R.S., Kochman, A. & Sikkema, K.J. (2002). Internalized stigma among people living with HIV/AIDS. AIDS and Behavior 6, 309-319.

Vanable, P.A., Carey, M.P., Blair, D.C. & Littlewood, R.A. (2006). Impact of HIV-related stigma on health behaviors and psychological adjustment among HIV-positive men and women. AIDS and Behavior 10, 473-482.

Rodkjaer, L., Laursen, T., Christensen, N.B., Lomborg, K., Ostergaard, L. & Sodemann, M. (2011). Changes in depression in a cohort of Danish HIV-positive individuals: Time for routine screening. Sexual Health 8, 214-221.

Rabkin, J.G. (2008). HIV and depression: Review and update. Current HIV/AIDS Reports 5, 163-171.

Rodkjaer, L., Laursen, T., Balle, N. & Sodemann, M. (2010). Depression in patients with HIV is under-diagnosed: A cross-sectional study in Denmark. HIV Medicine 11, 46-53.

Slot, M., Sodemann, M., Gabel, C., Kristoffersen, J., Laursen, T. & Rodkjaer, L. (2015). Factors associated with risk of depression and relevant predictors for screening for depression in clinical practice: A cross-sectional study among HIV-infected individuals in Denmark. HIV Medicine 16 (7) 393-402.

Rodkjaer, L., Sodemann, M., Ostergaard, L. & Lomborg, K. (2011). Disclosure decisions: HIV-positive persons coping with disease-related stressors. Qualitaitve Health Research 21, 1249-1259.

Rodkjaer, L., Chesney, M.A., Lomborg, K., Ostergaard, L., Laursen, T. & Sodemann, M. (2014). HIV-infected individuals with high coping self-efficacy are less likely to report depressive symptoms: A cross-sectional study from Denmark. International Journal of Infectious Diseases 22, 67-72.

Lazarus, J.V., Safreed-Harmon, K., Barton, S.E., Costagliola, D., Dedes, N., del Amo Valero, J. & Rockstroh, J.K. (2016). Beyond viral suppression of HIV: The new quality of life frontier. BMC Medicine 14, 94.

Basavaraj, K.H., Navya, M.A. & Rashmi, R. (2010). Quality of life in HIV/AIDS. Indian Journal of Sexually Transmitted Diseases 31, 75-80.

Wahbeh, H., Haywood, A., Kaufman, K. & Zwickey, H. (2009). Mind-body medicine and immune system outcomes: A systematic review. Open Complementary Medicine Journal 1, 25-34.

Park, E.R., Traeger, L., Vranceanu, A., Scult, M., Lerner, J., Benson, H., Denninger, J. & Fricchione, G.L. (2013). The development of a patient-centered program based on the relaxation response: The Relaxation Response Resiliency Program (3RP). Psychosomatics 54, 165-174.

Ludwig, D. & Kabat-Zinn, J. (2008). Mindfulness in medicine. Journal of the American Medical Association 300, 1350-1352.

Vranceanu, A., Gonzalez, A., Niles, H., Fricchione, G., Baim, M. & Yeung, A. (2014). Exploring the effectiveness of a modified comprehensive mind-body intervention for medical and psychologic symptom relief. Psychosomatics 55, 386-391.

Farber, E.W., Woods, A., Sherman, R.M., Sharma, S.M. & Campos, P.E. (2011). Personal meaning as a predictor of psychological well-being over time in individuals receiving HIV-related mental health services. General Hospital Psychiatry 33, 469-475.

Fumaz, C.R., Ayestaran, A., Perez-Alvarez, N., Muñoz-Moreno, J.A., Moltó, J., Ferrer, M.J. & Clotet, B. (2015). Resilience, aging, and quality of life in long-term diagnosed HIV-infected patients. AIDS Care 27, 1396-1403.

Brown, J.L. & Vanable, P.A. (2008). Cognitive-behavioral stress management interventions for persons living with HIV: A review and critique of the literature. Annals of Behavioral Medicine 35, 26-40.

Millard, T., Elliott, J. & Girdler, S. (2013). Self-management education programs for people living with HIV/AIDS: A systematic review. AIDS Patient Care STDs 27, 103-113.

Rodkjaer, L., Seeberg, K., Laursen, T., Dalum, A., Tolstrup, M., Drouin, M., & Ostergaard, L. (2014). The impact of a holistic intervention on self-efficacy and risk of depression in HIV-infected individuals in Denmark. Journal of HIV for Clinical and Scientific Research 1, 11-18.

Rodkjaer, L., Laursen, T., Seeberg, K., Drouin, M., Johansen, H., Dyrehave, C., Hønge, B. & Ostergaard, L. (2017). The effect of a mind–body intervention on mental health and coping self-efficacy in HIV-infected individuals: A feasibility study. The Journal of Alternative and Complementary Medicine 23, 1-5.

Campbell, M., Fitzpatrick, R., Haines, A., Kinmonth, A.L., Sandercock, P., Spiegelhalter, D. & Tyre, P. (2000). Framework for design and evaluation of complex interventions to improve health. British Medical Journal 321, 694-696.

Craig, P., Dieppe, P., Macintyre, S., Michie, S., Nazareth, I. & Petticrew, M. (2008). Developing and evaluating complex interventions: The new Medical Research Council guidance. British Medical Journal 337, a1655.

Hawk of the Yellow Wind. (2001). The circle of life. Copenhagen, Denmark: Lindhardt & Ringhof.

Drouin, M. (2017). Circle of life: A pathway to the heart. Mårslet Denmark: CHQ Publishing.

Benson, H. (1997). The relaxation response: Therapeutic effect. Science 278, 1694-1695.

Braun, V. & Clarke, V. (2006). Using thematic analysis in psychology. Qualitative Research in Psychology 3, 83.

Ritchie, J., Spencer, L. & O’Connor, W. (2003). Carrying out qualitative analysis. In: Qualitative research practice: A guide for social science students and researchers. Ritchie, J. & Lewis, J. (Eds.), pp. 219-262. London: Sage.

Fereday, J. & Muir-Cochrane, E. (2006). Demonstrating rigor using thematic analysis: A hybrid approach of inductive and deductive coding and theme development. International Journal of Qualitative Methods 5, 4.

Wenger, E. (1998). Communities of practice: Learning, meaning, and identity. Cambridge: Cambridge University Press.

Rueda, S., Mitra Logie C.H., Shi, Q., Morassaei, S. & Rourke, S.B. (2016). Examining the associations between HIV-related stigma and health outcomes in people living with HIV/AIDS: A series of meta-analyses. BMJ Open 6, e011453.

Fang, X., Vincent, W., Calabrese, S.K., Heckman T.G., Sikkema K.J., Humphries D.L. & Hansen N.B. (2015). Resilience, stress, and life quality in older adults living with HIV/AIDS. Aging & Mental Health 19, 1015-1021.



  • There are currently no refbacks.