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The relationship of psychological variables and disease progression among long-term HIV-infected men
S T Psychd1, M Troop, A P Burgess
1Psychological Medicine Unit, South Kensington & Chelsea Mental Health Centre, Chelsea & Westminster Hospital, London, UK.
Insights
Psychological factors impact HIV-1 progression. Gay men using acceptance coping strategies showed a significantly lower risk of developing AIDS-related complex or AIDS, highlighting its protective role in long-term HIV management.
Area of Science:
- Psychoneuroimmunology
- Clinical Psychology
- Infectious Diseases
Background:
- Long-term HIV-1 infection presents ongoing challenges for gay men.
- Psychological factors may influence disease progression in HIV-1.
- Understanding these factors is crucial for comprehensive HIV care.
Purpose of the Study:
- To investigate the role of psychological factors in HIV-1 disease progression.
- To identify specific coping strategies that predict clinical outcomes.
- To examine the relationship between psychological morbidity and disease advancement.
Main Methods:
- Longitudinal study of long-term HIV-1 infected gay men (up to 30 months follow-up).
- Self-report measures assessed coping strategies, life events, social support, personality, and psychological morbidity.
- Cox proportional hazards survival analyses were used to predict time to CD4<200 cells/mm³ and AIDS-related complex (ARC) or AIDS diagnosis.
Main Results:
- Acceptance coping emerged as a significant predictor of disease progression.
- Individuals in the lowest tertile of acceptance coping had nearly 5 times greater risk of ARC or AIDS diagnosis (HR=4.7).
- Viral load, antiretroviral drug use, and CD4 count were controlled for in the analyses.
Conclusions:
- Acceptance coping is a critical psychological factor in mitigating HIV-1 disease progression.
- Interventions promoting acceptance coping may improve clinical outcomes for gay men with long-term HIV-1.
- Psychological well-being is integral to managing chronic conditions like HIV-1.
Abstract:
This study investigated the contribution of psychological factors to disease progression among long-term HIV-1 infected gay men. Participants completed self-report measures including coping strategies, life events, social support, personality and psychological morbidity and were followed clinically for up to 30 months. Cox proportional hazards survival analyses were carried out to CD4<200 x 106/1 and AIDS-related complex (ARC) or AIDS diagnosis controlling for viral load, antiretroviral drug use and CD4 count. Only acceptance coping was a significant predictor of time to ARC or AIDS diagnosis: the risk of ARC or AIDS was almost 5 times greater for those scoring within the lowest tertile compared with those scoring in the highest tertile (HR=4.7, 95% CI 1.8-12.3).