In a 5.5-year study of HIV-infected men, researchers have found that the men's passage to AIDS status was greatly accelerated by stressful events and by low levels of social support.
The probability of progressing to AIDS during the 5.5-year period was two to three times higher for HIV-infected men with more than average stress or with less than average support than for those below the median on stress and above the median on social support, the study published in the June issue of Psychosomatic Medicine reports.
"We showed that for every increase in cumulative average stressful life events -- equivalent to one severe stressor or two moderate stressors -- the risk of AIDS was doubled," said Jane Leserman, Ph.D., of the University of North Carolina School of Medicine, who headed the group of eight scientists conducting the study.
Leserman said that the finding with regard to the cumulative effects of stressful life events "is perhaps among the most compelling evidence to date linking psychosocial variables with HIV disease progression."
They started with 82 asymptomatic HIV-infected gay men and tested the participants every six months for disease status (AIDS was determined by CD-4 lymphocyte count below 200 and/or having an AIDS indicator condition), depression, stressful life events, and social support. Thirty-three percent of the men progressed to AIDS, in an average time of 2.8 years. Eight men died of HIV-related causes.
Major depressive episodes were not significantly related to AIDS progression in the study itself, and few men were depressed at testing times. But there was a trend for men who developed AIDS to be twice as likely to have have had one or more major depressions before the onset of AIDS than those who did not develop AIDS.
She added, "Now we need to determine whether interventions that have been shown to reduce distress and improve social support can alter the course of HIV infection."
The study was supported by grants from the National Institute of Mental Health and the National Institutes of Health.
Psychosomatic Medicine is the official peer-reviewed journal of the American Psychosomatic Society, published bimonthly. For information about the journal, contact Joel E. Dimsdale, M.D., editor-in-chief, at 619-543-5468.