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All Journal Health Gate Interdisciplinary Journal of Ethnopsychiatric Nursing (IJEN)
Hasanudin Hasanudin
Poltekkes Kemenkes Malang
Religion Arts Humanities Dentistry Health Professions Medicine & Pharmacology Nursing Public Health

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Cognitive Behavioral Therapy for Mental Health and Stigma Among PLWH in Low and Middle-Income Countries: A Systematic Review Hasanudin Hasanudin; Sri Winarni; Elizabeth Risha Murlina Lema; Achmad Tirmidzi; Sunari Sunari
Health Gate Vol 4, No 2 (2026): April, 2026
Publisher : Dewan Pimpinan Daerah Persatuan Perawat Nasional Indonesia Kota Blitar

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.70111/hg4212

Abstract

burden of mental health disorders and HIV-related stigma, which critically hinders adherence to antiretroviral therapy (ART). Cognitive Behavioral Therapy (CBT) has emerged as a promising evidence-based psychological intervention. However, its effectiveness across diverse populations and delivery formats in LMICs has not been adequately synthesized. This systematic review aimed to evaluate the effectiveness of CBT on mental health and stigma reduction among PLWH in LMICs.  A systematic review was conducted in accordance with the PRISMA guidelines for RCT articles published in Scopus, Science Direct, and PubMed databases between January 1, 2021, to April 9, 2026. The keywords used were “Cognitive Behavioral Therapy” AND “Mental Health OR Stigma” AND “People Living with HIV” OR “Randomized Controlled Trial.” Risk of bias was assessed using the Cochrane Risk of Bias Tool version 2 (RoB 2). Seven RCTs involving 1.786 participants from six LMICs in Africa and one in South Asia were included. All studies consistently reported clinically significant reductions in depressive symptoms and internalized stigma following CBT interventions, regardless of group, individual, or self-administered delivery format, and regardless of whether the intervention was delivered by a mental health specialist or a trained non-specialist. The risk of bias assessment indicated that one study had a low risk of bias, and six studies had some concerns. CBT is an effective, flexible, and scalable intervention for improving mental health and reducing stigma among PLWH in LMICs. 
Classical Gamelan Music Therapy for Sleep Quality and Cardiovascular Parameters in Third-Trimester Pregnant Women: A Case Series Fitriana Kurniasari Solikhah; Hasanudin Hasanudin
Interdisciplinary Journal of Ethnopsychiatric Nursing Vol. 2 No. 1 (2026): Interdisciplinary Journal of Ethnopsychiatric Nursing
Publisher : Tarqabin Nusantara Group

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.62255/ijen.v2i1.217

Abstract

Background: Sleep disturbances severely impact third-trimester pregnant women, increasing adverseobstetric risks. Non-pharmacological interventions are strongly preferred, yet culturally congruenttherapies like classical gamelan music remain critically underexplored in clinical practice.Methods: In this prospective case series conducted between January and March 2026 in Indonesia, weenrolled three third-trimester pregnant women experiencing severe sleep disturbances (Pittsburgh SleepQuality Index [PSQI] >5). Participants received a 3-day classical gamelan music therapy regimen (10–15 minutes, twice daily). The primary outcomes included changes in PSQI global scores and sleepduration, as well as secondary cardiovascular parameters including blood pressure.Result: The three participants, aged 24 to 29 years, presented with severe baseline sleep fragmentation(mean PSQI 13.7). Following the intervention, individual PSQI scores decreased substantially (PatientA: 14 to 9; Patient B: 12 to 8; Patient C: 15 to 10). Mean nightly sleep duration increased from 3.8 to6.0 hours. Concurrently, resting heart rates decelerated from a mean of 102 bpm to 81 bpm, and systolicblood pressure normalized from 129 mmHg to 120 mmHg across all three individual participants.Conclusion: A brief regimen of classical gamelan music therapy appears feasible and is associated withmarked improvements in subjective sleep quality and autonomic regulation in third-trimester pregnantwomen. This culturally congruent, non-pharmacological intervention offers a safe, accessible adjunctivestrategy for gestational sleep management. Future large-scale randomised controlled trials withobjective polysomnographic endpoints are warranted to validate these preliminary findings and establishdefinitive clinical efficacy and safety.
Co-Authors Achmad Tirmidzi Elizabeth Risha Murlina Lema Solikhah, Fitriana Kurniasari Sri Winarni Sunari Sunari