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From the Departments of Psychiatry (J.L., E.D.J., R.N.G., S.G.S., D.O.P.), Medicine (J.L.), and Pathology and Laboratory Medicine (J.D.F.), University of North Carolina School of Medicine, Chapel Hill, North Carolina; Department of Biostatistics, University of North Carolina (J.C.), Chapel Hill, North Carolina; Departments of Psychiatry, Neuroscience, and Pharmacology, University of Florida College of Medicine (J.M.P.), Gainesville, Florida; and Departments of Psychiatry, Medicine, and Neuroscience, University of Pennsylvania School of Medicine (D.L.E.), Philadelphia, Pennsylvania.
Address reprint requests to: Jane Leserman, PhD, Research Associate Professor, Department of Psychiatry, CB 7160, University of North Carolina School of Medicine, Chapel Hill, NC 27599-7160. Email: JLeserman{at}css.unc.edu
OBJECTIVE: We examined the effects of stress, depressive symptoms, and social support on the progression of HIV infection.
METHODS: Eighty-two HIV-infected gay men without symptoms or AIDS at baseline were followed up every 6 months for up to 5.5 years. Men were recruited from rural and urban areas in North Carolina as part of the Coping in Health and Illness Project. Disease progression was defined using criteria for AIDS (CD4+ lymphocyte count of <200/µl and/or an AIDS-indicator condition).
RESULTS: We used Cox regression models with time-dependent covariates, adjusting for age, education, race, baseline CD4+ count, tobacco use, and number of antiretroviral medications. Faster progression to AIDS was associated with more cumulative stressful life events (p = .002), more cumulative depressive symptoms (p = .008), and less cumulative social support (p = .0002). When all three variables were analyzed together, stress and social support remained significant in the model. At 5.5 years, the probability of getting AIDS was about two to three times as high among those above the median on stress or below the median on social support compared with those below the median on stress or above the median on support, respectively.
CONCLUSIONS: These data are among the first to demonstrate that more stress and less social support may accelerate the course of HIV disease progression. Additional study will be necessary to elucidate the mechanisms that underlie these relationships and to determine whether interventions that address stress and social support can alter the course of HIV infection.
Key Words: HIV • AIDS • stress • social support • depression
Abbreviations: HIV = human immunodeficiency virus; HDRS = HamiltonDepression Rating Scale; CDC = Centers for Disease Control andPrevention.
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|
|
|
|
|
|
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|
|
|
|
|
|
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|
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