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Personality and HIV Disease Progression: Role of NEO-PI-R Openness, Extraversion, and Profiles of Engagement

From the Department of Psychology and Psychiatry (G.H.I., C.O., N.S.), University of Miami, Coral Gables, Florida; Laboratory of Personality and Cognition, (P.T.C., A.W.), National Institute on Aging, National Institutes of Health, Department of Health and Human Services, Baltimore, Maryland.

Address correspondence and reprint requests to Gail Ironson, Department of Psychology, University of Miami, P.O. Box 248185, Coral Gables, FL 33124-2070. E-mail: gironson{at}aol.com

Objective: To examine the role of the big five personality domains (Neuroticism, Extraversion, Openness, Agreeableness, Conscientiousness) and their respective facets and profiles on change in CD4 and log HIV-RNA copies/ml (VL) over 4 years. The examination of psychosocial predictors of disease progression in human immunodeficiency virus (HIV) has focused primarily on depression, coping, and stress, with little attention paid to stable individual differences.

Methods: A diverse sample of HIV-seropositive patients (n = 104) completed personality assessment (NEO-PI-R), underwent comprehensive psychological assessment and blood samples every 6 months for 4 years. Linear rates of change for CD4 cells and VL were modeled using Hierarchical Linear Modeling controlling for antiretrovirals (time dependent covariate), initial disease status, age, gender, ethnicity, and education.

Results: Domains that were significantly associated with slower disease progression over 4 years included Openness (CD4, VL), Extraversion (CD4, VL), and Conscientiousness (VL). Facets of the above domains that were significantly related to slower disease progression were assertiveness, positive emotions, and gregariousness (Extraversion); ideas, esthetics (Openness); achievement striving and order (Conscientiousness). In addition, profile analyses suggested personality styles which seem to underscore the importance of remaining engaged (e.g., Creative Interactors (E+O+), Upbeat Optimists (N–E+), Welcomers (E+A+), Go Getters (C+E+), and Directed (N–C+)) had slower disease progression, whereas the "homebody" profile (Low Extraversion-Low Openness) was significantly associated with faster disease progression.

Conclusions: These results provide good initial evidence of the relationship between personality and disease progression in HIV and suggest protective aspects of profiles of engagement. These finding may help identify those individuals at risk for poorer disease course and specify targets for psychosocial interventions.

Key Words: personality • HIV/AIDS • disease progression • Five-Factor Model • openness • conscientiousness

Abbreviations: VL = log HIV-RNA copies/ml; HIV = human immunodeficiency virus; NEO-PI-R = NEO Personality Inventory—Revised; N = Neuroticism; E = Extraversion; O = Openness; A = Agreeableness; C = Conscientiousness; FFM = Five-Factor Model; NEO-FFI = NEO-Five Factor Inventory; DSM = Diagnostic and Statistical Manual; IRB = Institutional Review Board; HAART = highly active antiretroviral therapy; SES = socioeconomic status; SD = standard deviation; ANCOVA = analysis of covariance; IR = increase ratios; DR = decline ratios; CI = confidence interval.