Effects of cognitive behavioral stress management on psychosocial adjustment, neuroendocrine functioning, and immunity in HAART-treated HIV+ gay and bisexual men

Date of Award




Degree Name

Doctor of Philosophy (Ph.D.)



First Committee Member

Michael H. Antoni, Committee Chair


The present investigation examined the efficacy of group-based Cognitive Behavioral Stress Management (CBSM) with individualized Medication Adherence Training (MAT) delivered by a licensed clinical pharmacist. CBSM+MAT (n = 76) was compared to MAT-Only (n = 54) on measures of psychosocial adjustment, adherence and other health-related behaviors, neuroendocrine regulation, and immune status. Data were collected at baseline, immediately following the 10-week CBSM intervention period, 9 months post-randomization, and 15 months post-randomization. In the 130 men randomized, we observed intervention-related reductions in depressed mood and denial during the 10-week training period. Furthermore, we determined that intervention-related reductions in denial may mediate decreases in depressed mood over the 10 weeks. Other intent-to-treat analyses indicated no effects of CBSM+MAT on health-related behaviors, neuroendocrine regulation, and immune status. However, in the 101 HIV+ men with detectable viral load at baseline, men randomized to CBSM+MAT (n = 61) displayed a .56 log10 reduction in HIV viral load over the 15 months while men in MAT-Only (n = 40) showed no change. Intervention-related reductions in depressed mood during the 10-week training period mediated the effect of CBSM+MAT on HIV viral load in men with detectable plasma levels at baseline. Results indicate that a time-limited CBSM+MAT intervention that modulates depressed mood may enhance the effects of HAART on suppression of HIV viral load in HIV+ gay and bisexual men who have a detectable viral load.


Psychology, Clinical; Gender Studies; Psychology, Physiological

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