Benefit finding, medication adherence, and cortisol as mediators of spirituality, religiousness, and immune status in HIV-seropositive gay and bisexual men

Date of Award




Degree Name

Doctor of Philosophy (Ph.D.)



First Committee Member

Michael Antoni - Committee Chair


This study examined the relationship of religiousness and immune status and putative mediators of that relationship (i.e. benefit finding, medication adherence, and cortisol) in a sample of 55 HIV seropositive gay and bisexual men. No significant relationship was found between religiousness and various measures of immune status, i.e. CD3+CD4+ cell count, CD3+CD8+ cell count, IgG antibody titers to HSV-2, viral load. Potential mediators could not be tested due to the non-significant immune Status-religiousness relationship. This research project also concluded that religion did not act as a moderator of spirituality and measures of immune status.Another focus of this study was to explore the relationship between benefit finding and religiousness. This relationship was found to be significant such that participants with greater religiousness found more benefits from being HIV positive. Psychosocial factors (i.e., social support, cognitive coping self-efficacy, openness to psychotherapy, acceptance coping, positive reinterpretation and growth coping) were tested as possible mediators of religiousness and benefit finding. Using multiple regression analyses, none of these variables mediated the religiousness-benefit finding association.Although cortisol could not be tested as a mediator of religiousness and immune status due to the non-significance of that relationship, analyses revealed associations between cortisol and two primary psychosocial variables. Religiousness and cortisol were found to be significantly negatively associated, as were cortisol and benefit finding. Greater religiousness and benefit finding were both independently related to lower production of cortisol. Exploratory analyses were undertaken to discern the relationship between religiousness, benefit finding, and cortisol. These analyses revealed that benefit finding mediated the relationship between religiousness and cortisol. Additionally, positive reinterpretation and growth coping mediated the benefit finding-cortisol relationship. Taken together, it is plausible that participants with greater religiosity experienced less cortisol output due in part to finding benefits in being HIV seropositive through the use of positive reinterpretation and growth coping.


Religion, General; Psychology, Clinical; Psychology, Cognitive; Psychology, Physiological

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