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Personality in a Cognitive-Behavioral Stress Management Intervention for HIV-Seropositive Men
Highly active antiretroviral therapy (HAART) adherence rates of 70 ? 80% often appear in the literature. However, it is estimated that 95% adherence must be achieved to cause virologic failure. Furthermore, if viral replication is not suppressed by HAART, the virus can mutate and become resistant to the patient?s current regimen and render it ineffective. Previous work has indicated that psychosocial factors like mood and personality may be related to outcomes such as adherence and disease progression. Interventions may improve adherence through modification of mood. Moreover, personality may impact the extent to which interventions can effectively impact adherence. The present study evaluated the role of personality in a 10-week Cognitive-Behavioral Stress Management (CBSM) intervention designed to improve HAART adherence. Analyses were performed on 93 ethnically diverse men who have sex with men (MSM) living with HIV/AIDS who were on high-active antiretroviral therapy, had completed the NEO Personality Inventory ? Revised, and were enrolled in an ongoing group-based CBSM intervention study. Repeated measures ANCOVAs, with income and number of HIV symptoms as covariates, showed (1) the intervention had no effect on HIV viral load; (2) high Conscientiousness was related to better HAART adherence; (3) CBSM buffered a drop in HAART adherence, as well as an increase in depressed mood in those low in Conscientiousness across the intervention period; (4) low Conscientiousness, as well as high Neuroticism was related to higher levels of depressed mood through 15-months post randomization. However, while allowing for the further analysis of ethnic group interactions, the utilization of multiple imputation to account for missing data due to attrition changed several relationships between variables of interest, HAART adherence, and depressed mood. Linear regression, controlling for relevant variables, showed that (5) neither Conscientiousness nor Neuroticism were related to CBSM session or medication adherence training session attendance. These findings show that personality factors such as Conscientiousness and Neuroticism and ethnic group membership are related to changes in mood and behaviors (i.e., HAART adherence) relevant to the treatment of MSM living with HIV/AIDS.