Title

Emotional status and social support relations to immune status in women co-infected with HIV and HPV: Preliminary evidence for beneficial psychosocial effects of a CBSM intervention tailored for this population

Date of Award

2002

Availability

Article

Degree Name

Doctor of Philosophy (Ph.D.)

First Committee Member

Michael H. Antoni, Committee Chair

Abstract

Women of color who are co-infected with Human Papillomavirus (HPV) and Human Immunodeficiency Virus (HIV), a population grossly understudied, are potentially vulnerable to major health consequences due to viral co-infection. This vulnerability is thought to be mediated by an impaired cell-mediated immune (CMI) response resulting from HIV-related immunosuppression. Little is known about the influence of psychosocial factors in immune surveillance mechanisms in women co-infected with HIV and HPV. The present study examines the nature of the relationships between emotional status and social support and their combined and interactive effects on immunological and health outcomes in 39 HIV+ HPV+ women. In addition, based on an existing literature revealing increased stress, depression, and social isolation in HIV+ women, we explored the psychosocial effects of a cognitive behavioral stress management (CBSM) intervention tailored for this population.In this study, we found that life stress (negative life events) was associated with more negative affect and greater depressive symptomatology. Social support was associated with positive affect, such as joy, affection, vigor, and contentment, and this relationship was strongest for women who had disclosed their HIV status to primary members of their social support network. As for relationships between psychosocial factors and immune status, both social support and positive affect were related to a greater percentage of T-cytotoxic/suppressor cells. Exploratory analysis revealed that the relationship between social support and immune status may be partially mediated by disclosure of one's HIV status. As for psychosocial effects of the CBSM intervention, preliminary results revealed intervention-related increases in perceptions social support as well as affectionate affect. These findings suggest CBSM intervention effects on perceptions of social support and emotional status, which had previously only been shown in HIV+ gay men.While further research into role of psychosocial factors in both immune functioning and health outcomes in HIV+ women remains necessary, efforts have begun to incorporate previously identified psychosocial risk factors for immunosuppression into psychosocial interventions that address these needs. Future research efforts are needed to delineate the psychological and physical health benefits of psychosocial interventions with HIV+ women who are at risk for the development of cervical cancer.

Keywords

Psychology, Clinical; Health Sciences, Immunology

Link to Full Text

http://access.library.miami.edu/login?url=http://gateway.proquest.com/openurl?url_ver=Z39.88-2004&rft_val_fmt=info:ofi/fmt:kev:mtx:dissertation&res_dat=xri:pqdiss&rft_dat=xri:pqdiss:3071257