NEGATIVE AFFECTIVITY, COPING, IMMUNE STATUS, AND DISEASE PROGRESSION IN HIV-INFECTED INDIVIDUALS

The primary goal of the study was to assess the relationship between p ersonality dispositions, coping styles, immune markers, clinical statu s, and subjective somatic symptoms in a mixed sample of HIV positive i ndividuals. Specifically, the prognostic value of psychological and im munological measures in HIV progression was emphasized. Subjects (n = 104) were recruited from a cohort of 422 HIV positive individuals enro lled in the Oslo HIV Cohort Study. The participants were given self-ad ministered questionnaires assessing behavioral, psychological, and psy chosocial variables. Clinical assessment and immunological tests were performed at regular follow-up visits. Clinical status was assessed ac cording to the Centers for Disease Control criteria. The immune marker s used were CD4 T cell counts, beta2-microglobulin concentration, seru m levels of HIV-1 p24 core protein, and levels of antibodies to core p rotein. In addition, subjective somatic symptoms were assessed. The re sults showed that measures of negative affectivity (NA; e.g. anxiety, distress, tension) were consistently related to subjective somatic sym ptoms and passive-defensive coping style. However, no consistent assoc iation between NA measures and immune markers was found. Individuals w ho developed AIDS in the study period had significantly lower initial CD4 cell counts as well as lower scores on measures of active-problem related coping (e.g. Positive reappraisal, Seeking social support) and passive-defensive coping (i.e. Escape-Avoidance, Self-control). The r esults suggest (1) that coping styles may merit a specific focus in fu ture research of psychological factors and medical outcomes in HIV inf ection, and (2) because of associations of NA measures with symptom re ports studies of the relationship between e.g. stress, depression and HIV outcome should consider these variables as confounders.