Reductions in herpes simplex virus type 2 antibody titers after cognitive behavioral stress management and relationships with neuroendocrine function, relaxation skills, and social support in HIV-positive men

Objective: Coinfection with herpes simplex virus type 2 (HSV-2) is common i n individuals infected with human immunodeficiency virus (HIV) and may have health implications. This study examined the effect of a 10-week cognitive behavioral stress management (CBSM) intervention on immunoglobulin G (IgG) antibody titers to HSV-2 in a group of mildly symptomatic HIV-infected gay men and the degree to which these effects were mediated by psychosocial an d endocrine changes during the 10-week period. Methods: Sixty-two HIV+ gay men were randomly assigned to either a 10-week CBSM intervention (N = 41) o r a wait-list control condition (N = 21). Anxious mood, social support, cor tisol/dehydroepiandrosterone sulfate (DHEA-S) ratio levels, and HSV-8 IgG a ntibody titers were assessed at baseline and after the 10-week period. CBSM participants also recorded their stress levels before and after at-home re laxation practice. Results: HSV-2 IgG titers were significantly reduced in the CBSM participants but remained unchanged in the control group after the 10-week intervention period. Increases in one type of social support, perc eived receipt of guidance, during the 10 weeks was associated with and part ially mediated the effect of the intervention on HSV-2 IgG, Similarly, decr eases in cortisol/DHEA-S ratio levels were associated with decreases in HSV -2 IgG, and lower mean stress levels achieved after home relaxation practic e were associated with greater decreases in HSV-2 IgG among CBSM participan ts, Conclusions: These findings suggest that behavioral and psychosocial ch anges occurring during CBSM interventions, including relaxation, enhanced s ocial support, and adrenal hormone reductions, may help to explain the effe cts of this form of stress management on immune indices such as HSV-2 antib ody titers.