1. Introduction
The Human Immunodeficiency Virus (HIV)/Acquired Immunodeficiency Syndrome (AIDS) is a highly challenging and overwhelming disease with numerous consequences [1]. One of the crucial issues related to HIV patients, which has attracted very little attention, is a lifestyle [6]. When selecting a lifestyle for improving one’s health and preventing diseases, the individual engages in behaviors, such as following suitable nutrition, considering good levels of sleep and activity, maintaining a good shape, refraining from smoking and drinking alcohol, and taking protective measures against various diseases [8]. Health-Related Quality of Life (HRQoL) is defined as the individual’s satisfaction with all the aspects of their life [13]. Schema therapy is a novel integrated treatment method, which provides a regular plan for identifying and adjusting Early Maladaptive Schemas (EMS) formed in the individual’s past. The primary basis for schema therapy is classic cognitive-behavioral therapy [17]. Dialectical Behavior Therapy (DBT) emphasizes structure by considering pathological symptoms inefficient problem solving [19]. The main objective of the current study was to compare the effectiveness of schema therapy and DBT on Health-Promoting Lifestyles (HPL) and Quality of Life (QoL) in HIV/AIDS patients.  
2. Materials & Methods 
This was an experimental study with pre-test-post-test and a control group design. Regarding the objectives, the current study is an applied research. The study’s statistical population included all HIV patients monitored by behavioral disorders clinics of the Healthcare Organization of Hamedan Province of Iran in 2019-2020. Using the simple random sampling method, 45 patients were randomly selected from Shohada Clinic in Hamedan City, Iran, as the study sample, then randomly assigned them into three 15-member groups, i.e., two intervention groups and a control group. Then, 8 Schema Therapy (ST) sessions were administered for the first intervention group, and 8 DBT sessions were administered for the second intervention group. Data collection tools were: The Health-Promoting Lifestyle Profile (HPLP) was designed by Walker et al. in 1987. This questionnaire includes 52 items, measuring 6 components. These 6 aspects include nutrition, physical activity, health responsibility, stress management, interpersonal support, spiritual growth [27]. The Short Form (36) Health Survey (SF-36) includes 36 items, and 8 subscales were designed by Ware & Sherbourne 1992. The 8 subscales include physical functioning, physical role functioning, emotional role functioning, energy/fatigue, emotional wellbeing, social functioning, pain, and general health. Moreover, using two primary subscales, physical and mental health, are obtained [28].
3. Results
Multivariate Analysis of Variance (MANCOVA) was employed for data analysis. The collected data were analyzed in SPSS. Table 1 reports the Mean±SD scores of the subscales of HPL and QoL in the 3 surveyed groups.


According to significant F-value calculated for comparison between mean values of two schema therapy and dialectical behavior therapy groups, Lametrix post hoc test was employed for variables, including HPL (nutrition, physical activity, health responsibility, stress management, interpersonal relations, & spiritual growth) and quality of life QoL (physical health, mental health). According to Table 2, there was a significant post-test difference between experimental groups, i.e., affected by ST and DBT regarding values of HPL components; nutrition (2.722), physical activity (2.781), health responsibility (3.724), stress management (3.716), interpersonal relations (2.964), and spiritual growth (4.846) and QoL components; physical health (2.582) and mental health (2.989) ).


According to the MANCOVA data (based on the odds of 0.99), the research hypothesis was confirmed; thus, ST and DBT provided a different effect on HPL, as well as the QoL in patients with HIV (P=0.001).
 4. Discussion & Conclusion
To explain the findings, in ST, by identifying EMSs through cognitive and experiential techniques and behavioral pattern-breaking, the individual’s lifestyle and QoL can be improved. The maladaptive schemas of HIV patients often create problems with lifestyle and QoL; thus, modifying the schemas of these individuals can somewhat result in changes in the openness to experience. HIV patients may experience social isolation, failure, and dysfunctional schemas. These schemas can affect the individual due to effects and deficiencies that lead to a repetitive life and the inability to notice new experiences and events. Furthermore, concerning the superiority of ST, this therapeutic method focuses on cognitive, emotional, and behavioral themes; therefore, it can be helpful through techniques such as establishing relations between current problems and the schemas, evaluating the benefits and disadvantages of coping mechanisms, challenging schemas, imaginary dialogue, mental visualization, overcoming the barriers for changing behaviors, and creating significant life changes.
Moreover, the multidimensional nature of ST makes it more effective than DBT. The present study results revealed that ST, to identify underlying patterns of thought and challenge them, explicitly focusing on relation therapy, paying attention to the past and the present, attempting to break the patterns of maladaptive behaviors; applying experiential techniques, is a more comprehensive therapeutic method compared to DBT. Therefore, it was more effective in changing the HPL and QoL of individuals compared to DBT.

Ethical Considerations
Compliance with ethical guidelines
The Ethics Committee of Hamedan University of Medical Sciences approved the study (Code: IR.UMSHA.REC.1398.1063). This study has been registered in the Iranian Registry of Clinical Trials (Code: IRCT20120215009014N348).

Funding
This study was extracted from the PhD. dissertation of the first author at Department of Psychology, Kermanshah Branch, Islamic Azad University, Kermanshah. 

Authors' contributions
All authors met the standard writing criteria based on the recommendations of the International Committee of Medical Journal Publishers. 

Conflicts of interest
The authors declared no conflicts of interest.

Acknowledgements
The authors would like to wholeheartedly thank Hamedan University of Medical Sciences and all the participants in the current study.


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