This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Ironson, G. Articles by Hayward, H. Search for Related Content PubMed PubMed Citation Articles by Ironson, G. Articles by Hayward, H. Related Collections Immunology Personality Stress and Coping HIV/AIDS

Do Positive Psychosocial Factors Predict Disease Progression in HIV-1? A Review of the Evidence

From the Department of Psychology (G.H.I.), University of Miami, Coral Gables, Florida, and the Department of Psychology (H.H.), Harvard University, Cambridge, Massachusetts.

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

Adding to a traditional stress perspective, behavioral medicine has been focusing increasingly on investigating the potential impact of positive psychosocial factors on disease course in HIV. Dispositional optimism, active coping, and spirituality show the most evidence for predicting slower disease progression, although the data are not entirely consistent. Findings for the role of social support are mixed, although indications are that it may be particularly helpful at later stages of illness. Many of the other constructs (positive affect, finding meaning, emotional expression/processing, openness, extraversion, conscientiousness, altruism, and self-efficacy) have only been examined in one or two studies; results are preliminary but suggestive of protective effects. Plausible behavioral and biological mechanisms are discussed (including health behaviors, neurohormones, and immune measures) as well as suggestions for clinicians, limitations, future directions, and a discussion of whether these constructs can be changed. In conclusion, investigating the importance and usefulness of positive psychosocial factors in predicting disease progression in HIV is in its beginning scientific stages and shows good initial evidence and future promise.

Key Words: optimism • coping • spirituality • positive psychology • meaning • HIV/AIDS • disease progression

Abbreviations: HAART = highly active antiretroviral therapy; NE = norepinephrine; VL = viral load; ARC = AIDS-related complex.

This article has been cited by other articles:

				J. Leserman and L. R. Temoshok A Road Well Traveled (Although Not Yet a Super Highway) Psychosom Med, June 1, 2008; 70(5): 521 - 522. [Full Text] [PDF]

				N. Klimas, A. O. Koneru, and M. A. Fletcher Overview of HIV Psychosom Med, June 1, 2008; 70(5): 523 - 530. [Abstract] [Full Text] [PDF]

				S. W. Cole Psychosocial Influences on HIV-1 Disease Progression: Neural, Endocrine, and Virologic Mechanisms Psychosom Med, June 1, 2008; 70(5): 562 - 568. [Abstract] [Full Text] [PDF]

				A. W. Carrico and M. H. Antoni Effects of Psychological Interventions on Neuroendocrine Hormone Regulation and Immune Status in HIV-Positive Persons: A Review of Randomized Controlled Trials Psychosom Med, June 1, 2008; 70(5): 575 - 584. [Abstract] [Full Text] [PDF]

				L. R. Temoshok, R. L. Wald, S. Synowski, and A. Garzino-Demo Coping as a Multisystem Construct Associated With Pathways Mediating HIV-Relevant Immune Function and Disease Progression Psychosom Med, June 1, 2008; 70(5): 555 - 561. [Abstract] [Full Text] [PDF]

				J. Leserman Role of Depression, Stress, and Trauma in HIV Disease Progression Psychosom Med, June 1, 2008; 70(5): 539 - 545. [Abstract] [Full Text] [PDF]