EFFECTS OF AIDS-RELATED BEREAVEMENT ON HIV PROGRESSION AMONG NEW-YORK-CITY GAY MEN

This study investigates the relationship between early AIDS-related be reavement and subsequent changes in CD4 T-cell levels and health over a three- to four-year follow-up period in 85 HIV positive gay men. In addition, two psychological responses to loss, grief, and depression w ere distinguished and used as predictors of changes in health followin g loss. Interview data collected each year was used to assess psycholo gical, behavioral and health factors. Blood samples drawn yearly were used to assess CD4 T-cell levels. Results indicate that those who had experienced an AIDS-related bereavement event prior to entry into the study showed a more rapid loss of CD4 T-cells over time, controlling f or age, initial health status, use of antiretrovirals, sedatives, recr eational drugs, cigarettes, and alcohol as well as other potential con founding factors. CD4 loss-rate differences were observable by two yea rs post-bereavement. In addition, grief reactions were distinguishable from depressive reactions. Grief reactions were unrelated to CD4 decl ine and symptom onset while aspects of depression, specifically self-r eproach, were predictive of CD4 loss. These data suggest that bereavem ent may impact biological systems relevant to HIV progression and that distinguishing specific responses to loss may improve our understandi ng of these relationships.