PSYCHOSOCIAL STRESS, ENDOCRINE AND IMMUNE-RESPONSE IN HIV-1 DISEASE

Individuals infected with the HIV virus face a multitude of stressors. First is the stress of finding out one is HIV seropositive (Ironson e t al., 1990). Next is the stress associated with uncertainty of when s ymptoms will appear. As the disease progresses loss of job, loss of he alth insurance, and loss of independence can be major stressors. Many of these gay men have the additional stress of loss of a partner due t o HIV, or loss of social support due to the stigma attached to being H IV positive or being gay. This high rate of stressors is accompanied b y high rates of affective distress including a higher rate of depressi on (Goodkin, 1988), suicide (Marzuk et al., 1988) and anxiety, especia lly when symptoms appear (Atkinson et al., 1988, Nichols, 1983). For t he past seven years, our group has been studying the influences of psy chosocial stress and responses to this stress on affective, endocrine and immune responses in HIV-1 seropositive gay men. We focus on this g roup partly because of the high level of stress they are under and als o because the literature suggests that many of the stressors noted abo ve could have a negative impact on the immune system, and therefore co uld possibly influence disease progression. The purpose of this chapte r therefore is to briefly review our research findings in the context of the literature in order to explore the interactive nature of affect ive, endocrine and immune responses.