Impact of stressful life events, depression, social support, coping, and cortisol on progression to AIDS.
Am J Psychiatry
; 157(8): 1221-8, 2000 Aug.
Article
em En
| MEDLINE
| ID: mdl-10910783
ABSTRACT
OBJECTIVE:
This study examined prospectively the effects of stressful events, depressive symptoms, social support, coping methods, and cortisol levels on progression of HIV-1 infection.METHOD:
Eighty-two homosexual men with HIV type-1 infection without AIDS or symptoms at baseline were studied every 6 months for up to 7. 5 years. Men were recruited from rural and urban areas in North Carolina, and none was using antiretroviral medications at entry. Disease progression was defined as CD4(+) lymphocyte count <200/microl or the presence of an AIDS indicator condition.RESULTS:
Cox regression models with time-dependent covariates were used adjusting for race, baseline CD4(+) count and viral load, and cumulative average antiretroviral medications. Faster progression to AIDS was associated with higher cumulative average stressful life events, coping by means of denial, and higher serum cortisol as well as with lower cumulative average satisfaction with social support. Other background (e.g., age, education) and health habit variables (e.g., tobacco use, risky sexual behavior) did not significantly predict disease progression. The risk of AIDS was approximately doubled for every 1.5-unit decrease in cumulative average support satisfaction and for every cumulative average increase of one severe stressor, one unit of denial, and 5 mg/dl of cortisol.CONCLUSIONS:
Further research is needed to determine if treatments based on these findings might alter the clinical course of HIV-1 infection.
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Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Apoio Social
/
Hidrocortisona
/
Síndrome da Imunodeficiência Adquirida
/
Transtorno Depressivo
/
Acontecimentos que Mudam a Vida
Tipo de estudo:
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Aspecto:
Determinantes_sociais_saude
Limite:
Adult
/
Humans
/
Male
/
Middle aged
Idioma:
En
Revista:
Am J Psychiatry
Ano de publicação:
2000
Tipo de documento:
Article
País de afiliação:
Estados Unidos