EMOTIONAL DISTRESS, COPING, AND ADJUSTMENT IN HUMAN-IMMUNODEFICIENCY-VIRUS INFECTION AND ACQUIRED-IMMUNE-DEFICIENCY-SYNDROME

Fifty-seven ambulatory, human immunodeficiency virus (HIV)-infected pa tients at various stages of disease progression and 17 HIV seronegativ e controls were examined in a cross-sectional study with self-administ ered measures of emotional distress, coping, and adjustment to illness . All infected and control subjects were homosexual or bisexual and fr ee of acute medical illness. The findings indicated that both uninfect ed and infected subjects had enhanced emotional distress in a variety of domains. However, while somatic and cognitive-ruminative complaints were greater in symptomatic subjects relative to controls, depression and anxiety were not. Professed coping strategies were heterogeneous and not particularly related to HIV diagnostic status, with the except ion of planful problem solving which was decreased for acquired immune deficiency syndrome subjects. Disruption in several aspects of daily life adjustment was markedly increased in symptomatic subjects. The fi ndings suggest that both HIV seropositive status and perceived risk fo r infection produce a sustained level of generalized psychological dis tress. Even in the absence of current medical illness, patients with a dvanced disease progression are concerned primarily with anticipated m edical implications and cognitive effectiveness.