Publication Date



Open access

Embargo Period


Degree Type


Degree Name

Master of Science (MS)


Psychology (Arts and Sciences)

Date of Defense


First Committee Member

Gail Ironson

Second Committee Member

Rick Stuetzle

Third Committee Member

David Kling


Objective: The purpose of the present study was to examine whether spiritual coping (SC) was related to health behaviors, specifically medication adherence, safer sex practices, and substance use as well as depression levels in an HIV+ population over a two year period. In addition, the present study examined whether spiritual coping predicted changes in medication adherence and depression levels over time. Methods: This longitudinal study assessed 177 HIV+ and diverse men and women in the midrange of illness as indicated by a CD4 number between 150 and 500 and no previous AIDS-defining symptom. Spiritual coping data and safer sex data were assessed from interviews conducted at baseline assessment and at each follow-up assessment every 6 months for a period of 2 years. Linear Regression was used to examine the relationship between Spiritual Coping and baseline medication adherence, safer sex practices, substance use, and baseline depression levels. Hierarchical Linear Modeling was used to examine whether S change over time in medication adherence and depression controlling for age, gender, ethnicity, education, anti-HIV medication and baseline values for each outcome. Results: Spiritual Coping was not significantly related to medication adherence, substance use, safer sexual practices, or depression. Spiritual coping did not significantly predict changes in medication adherence or depression over time. However, subcodes showed that spiritual conflict, spiritual struggle and spiritual guilt were related with less marijuana use, less cocaine use, and to less use of protection in participants reporting sexual activity with more than one partner, respectively. Conclusions: Negative spiritual coping strategies were related to more substance use and risky sexual behaviors in participants reporting sexual activity with more than one partner. No significant relationships were found between spiritual coping and medication adherence or depression. Findings indicate that negative spiritual coping is related to negative health behaviors. These findings suggest that future interventions aimed at reducing negative spiritual coping should be developed as they may help to reduce substance use and risky sexual behaviors in people with HIV.


HIV; Spirituality; adherence; substance use; risky sex