The effects of a cognitive/behavioral stress management program on psychological distress and the immune system in HIV-1 seropositive and seronegative gay men

Date of Award




Degree Name

Doctor of Philosophy (Ph.D.)

First Committee Member

Michael H. Antoni, Committee Chair


Psychological and immunologic effects of a ten week cognitive/behavioral stress management (CBSM) program were assessed for HIV-1 seropositive (HIV+) and seronegative (HIV$-$) gay men. Forty-nine gay men were randomly assigned to a CBSM group (N = 14 HIV$-$; N = 10 HIV+) or an assessment only control group (N = 16 HIV$-$; N = 9 HIV+). Both groups learned of their HIV-1 serostatus during the 5th week of the protocol. The CBSM group met twice a week for ten weeks and the program consisted of cognitive restructuring techniques, assertiveness training, coping skills, and progressive muscle relaxation training. In addition to psychological (anxiety, depression) and immunologic (CD4#, CD56#, NKCC, PHA, PWM) measures, both groups were assessed on potential immunomodulatory confounds (i.e., alcohol abuse, sleep, physical activity, sexual behavior). An additional seven HIV+ subjects served in a second protocol and received the same CBSM program but entered the study already knowing their HIV serostatus. Differences in psychological distress measures between protocols were examined. Within protocol 1 HIV$-$ controls showed a decrease in anxiety while HIV$-$ CBSM subjects showed a marginal increase across the 10 week period. Similarly, HIV+ controls also significantly reduced anxiety while HIV+ CBSM subjects showed no changes across the 10 weeks. No changes were found in depression for any of the groups. HIV$-$ CBSM subjects showed significant increases in CD4# while HIV$-$ controls showed increases in lymphocyte responsivity to PHA across the 10 weeks. Relaxation frequency was associated with decreases in anxiety for HIV$-$ men when post-notification effects were partialled out. No significant relationships were found between relaxation frequency and distress for HIV+ subjects. HIV+ subjects, however, showed positive associations between relaxation frequency and both PWM and NKCC values. Finally, no differences in psychological distress were found between protocol 1 and protocol 2, suggesting that participation in the program itself rather than HIV-1 status notification was responsible for changes in distress measures.


Psychology, Psychobiology; Psychology, Behavioral

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