Behavioral Mediation of the Relationship Between Psychosocial Factors and HIV Disease Progression

Abstract

The psychological and physical demands of coping with medication side effects and comorbid illnesses can be overwhelming and may influence behaviors, such as medication adherence, substance use, sexual risk behavior, and exercise that, in turn, affect health outcomes. Cross-sectional and prospective studies among diverse populations of persons living with HIV suggest that these behavioral mechanisms may be associated with HIV disease progression. The motivation to change behavior is often highest in the immediate aftermath of a stressor. However, over time the motivation to continue a particular behavior change is often challenged by habits, environmental influences, and psychosocial factors. Furthermore, a number of studies suggest that behavioral mechanisms may mediate the relationship between psychosocial variables (e.g., stress, depression, coping, and social support) and disease progression in HIV. Thus, developing clinical interventions that address these psychosocial factors and enhance protective health behaviors and reduce behaviors that convey risk to health are likely to lessen overall morbidity and mortality among patients living with HIV/AIDS.

Qualidade de vida de pacientes idosos vivendo com HIV/AIDS

“…Existem evidências de que o estresse pode acelerar a progressão do HIV/AIDS, aumentando a replicação viral e suprimindo a resposta do sistema imunológico 7 . Além disso, os soropositivos também podem enfrentar problemas como depressão, isolamento, estigmatização e discriminação, que podem levar a eventos traumáticos de vida e causar impacto negativo e progressivo no curso da doença 8 .…”

Living with HIV: Responses to a Mantram Intervention Using the Critical Incident Research Method

“…1 The psychologic and physical demands of coping with complex medication regimens, side-effects of treatment, symptom severity, as well as comorbid illnesses can be overwhelming and may influence health care behaviors such as medication adherence, substance use, sexual risk taking, or other behaviors that influence health outcomes. 1,2 In addition, persons living with HIV disease often experience psychosocial challenges such as depression, isolation, and traumatic life events that can impact the course of HIV disease progression. 2,3 Evidence suggests that stress may hasten HIV disease progression by increasing viral replication and suppressing the immune response.…”

“…1,2 In addition, persons living with HIV disease often experience psychosocial challenges such as depression, isolation, and traumatic life events that can impact the course of HIV disease progression. 2,3 Evidence suggests that stress may hasten HIV disease progression by increasing viral replication and suppressing the immune response. [4][5][6] Intervention studies using combinations of cognitive and relaxation therapies in the era of highly active antiretroviral therapy have shown improvements in psychologic quantitative measures in HIV-infected persons.…”

Comparison of effects of isoniazid plus ART and ART only regimen on the incidence of tuberculosis and HIV progression in HIV positive patients: a retrospective cohort study at two hospitals in Addis Ababa, Ethiopia

“…30 In addition, findings of a cohort study in Boston demonstrated a clinically and statistically nonsignificant effect of heavy alcohol consumption on HIV progression among persons on ART, controlled for medication adherence. 31 Contradictory to these studies, tobacco smoking was shown in a US study to increase risks of AIDS-defining illnesses like respiratory infections and to decrease immune and virologic responses to HAART. 32 Consistently, a systemic review had identified 10 studies using progression to AIDS as an end point; of which nine found no relation with tobacco smoking.…”