The authors examined a dynamic conceptualization of stress by investigating how economic stress, measured in terms of material loss, alters women's personal and social resources and how these changed resources impact anger and depressive mood. Resource change in women's mastery and social support over 9 months was significantly associated with changes in depressive mood and anger among 714 inner city women. Greater loss of mastery and social support was associated with increased depressive mood and anger. Loss of mastery and social support also mediated the impact of material loss on depressive mood and anger. Resource loss and worsening economic circumstances had more negative impact than resource gain and improving economic circumstances had positive impact, suggesting the greater saliency of loss than gain.

We examined the differential impact of chronic versus acute economic stress on depressive mood among a sample of 1241 low-income, single, European and African American women. Based on Hobfoll's (1988, 1989) conservation of resources (COR) theory, we predicted that acute resource loss would be more distressing than chronic economic lack. That is, although chronically impoverished conditions are stressful, the attendant resource losses created will be more distressing. We further predicted that mastery and social support would be more beneficial in offsetting the negative consequences of acute resource loss than the negative consequences of chronic economic lack, because acute loss creates identifiable demands that resources may address. Hence, we hypothesized that mastery and social support would show stress buffering effects only for material loss, not chronic lack. The findings generally supported the hypotheses, but mastery buffered only European American women's resource loss and social support buffered only African American women's resource loss. The findings are discussed in light of implications for prevention within theoretical and cultural contexts.

Objective Cervical intraepithelial neoplasia (CIN) is greatly increased in women infected with sexually transmitted Human Papillomaviruses (HPVs) and who are co-infected with Human Immunodeficiency Virus (HIV) infection. Factors associated with promotion of HPV to CIN in these women include degree of immunosuppression and preventable behavioral factors such as tobacco smoking and psychological stress. Interventions such as cognitive behavioral stress management (CBSM) decrease stress and modulate disease activity in HIV-infected men though effects have not been established in HIV-infected women. This study examined the effects of CBSM on life stress and CIN in HIV+ minority women. Methods Participants were 39 HIV+ African American, Caribbean and Hispanic women with a recent history of an abnormal Papanicolaou smear. Participants underwent colposcopic examination, psychosocial interview, and peripheral venous blood draw at study entry and 9 months after being randomly assigned to either a 10-week CBSM group intervention (n = 21) or a one-day CBSM workshop (n = 18). Results Women assigned to the 10-week CBSM intervention reported decreased perceived life stress and had significantly lower odds of CIN over a 9-month follow-up, independent of CIN at study entry, HPV type, CD4+CD3+ cell count, HIV viral load, and tobacco smoking. Women free of CIN at follow-up reported decreases in perceived stress over time while those with CIN reported increases in perceived stress over the same period. Conclusion Although preliminary these findings suggest that stress management decreases perceived life stress and may decrease the odds of CIN in women with HIV and HPV.

BackgroundAlcohol consumption has been associated with poor antiretroviral therapy (ART) adherence but less is known about its relationship to HIV viral suppression, or whether certain drinking patterns have a stronger association than others. The objectives of this study were to determine the association of different patterns of alcohol consumption to HIV viral suppression and ART adherence, and to determine whether any associations of alcohol with HIV viral suppression were mediated by poor ART adherence.MethodsThis observational study used baseline data from 619 HIV+ participants, recruited across 8 clinical and community settings across Florida as part of the Florida Cohort from 2014 to 2016. Alcohol consumption was measured by self-report, and grouped into four categories: heavy drinking (>7/week for women or >14 drinks/week for men); binge, but not heavy drinking (≥4 or >5 drinks/occasion for women and men, respectively), low level drinking (neither heavy nor binge), and abstinence. Serum HIV RNA measurements were obtained from statewide HIV surveillance data, and durable viral suppression was defined as achieving HIV viral suppression (<200 copies/ml) at every assessment in the past 12 months.ResultsThe majority of the 619 participants were male (63%) and aged 45 or greater (65%). The proportion of participants with heavy, binge, low-level drinking and abstinence was 9, 25, 37 and 30%, respectively. Optimal ART adherence (≥95%) was reported by 68%, and 60% achieved durable viral suppression. In multivariable analysis controlling for demographic factors, drug use, and homelessness, heavy drinking (compared to abstinence) was associated with increased odds of failing to achieve durable viral suppression (OR 2.16, 95% CI 1.08–4.32) whereas binge drinking alone was not significantly associated with this outcome (OR 1.04, 95% CI 0.64–1.70). Both heavy drinking and binge drinking were significantly associated with suboptimal ART adherence. Mediation analyses suggested that only a small proportion of the relationship between heavy drinking and suboptimal viral suppression was due to poor ART adherence.ConclusionsExceeding weekly recommended levels of alcohol consumption (heavy drinking) was significantly associated with poor HIV viral suppression and ART non-adherence, while binge drinking was associated with suboptimal ART adherence in this sample. Clinicians should attempt to address heavy drinking in their patients with HIV.

The authors examined congruence in the negative emotions (depression, anger) of 101 female osteoarthritis patients (M age = 69 years) and their caregiving husbands (M age = 71 years) and the extent to which patients' pain behavior (e.g., limping, rubbing joints) exacerbated linkages between partners' negative emotions. Associations between patients' and husbands' emotions were examined within domains (e.g., depression-depression) and across domains (e.g., depression-anger) over a 6-month interval. Regression analyses revealed that patients' initial levels of depressive symptoms and anger were related to increases in their husbands' anger over time. The associations between patients' depressive symptoms and their husbands' depressive symptoms and anger were conditioned by pain behaviors. Patients who were more depressed and who engaged in high levels of pain behavior had husbands who became more depressed and angry.