Examining Associations Between Cognitive-Affective Vulnerability and HIV Symptom Severity, Perceived Barriers to Treatment Adherence, and Viral Load Among HIV-Positive Adults

Abstract

Background Little research on symptom impairment and quality of life among HIV-positive (HIV+) individuals has attended to the potential role of cognitive-affective vulnerabilities. Emerging research indicates that emotion regulation (ER), anxiety sensitivity (AS), and distress tolerance (DT) are associated with a range of mental health outcomes and demonstrate meaningful relations to clinical outcomes in HIV+ individuals. Purpose In this investigation, we sought to concurrently examine these factors in relation HIV symptom severity, barriers to medication adherence, and disease viral load. Method Participants were 139 HIV+ individuals (34 female; age M=48.2 years, SD=8.1, 42 % Black) receiving outpatient HIV care and prescribed at least one antiretroviral medication.We used hierarchical regression analyses to concurrently examine ER, AS, and DT in relation to severity of HIV symptoms, barriers to medication adherence, and disease viral load. Results After accounting for alcohol use problems, cannabis dependence, gender, and education, AS was significantly associated with HIV symptom severity (β = .35, p <.01) whereas ER evidenced a trend relation (β=.19, p=.07). ER (β=.45, p<.01), but not AS or DT, was significantly related to barriers to medication adherence, above and beyond variance accounted for by covariates. Finally, ER evidenced a trend level relation to viral load (β=.21, p=.07), above and beyond variance accounted for by cannabis use. Conclusion Findings provide an extension of previous research, suggesting unique roles of cognitive-affective vulnerabilities in terms of HIV symptom severity, medication use barriers, and infection symptomatology, and inform the refinement of current treatments for HIV+ individuals so as to improve functioning.

Anxiety symptoms and disorders among adults living with HIV and AIDS: A critical review and integrative synthesis of the empirical literature

“…Results indicated that anxiety sensitivity cognitive concerns predicted suicidality incrementally above and beyond the effects of demographic and health-related covariates and negative affectivity. The most recent study, conducted by Leyro et al (2015), cross-sectionally examined the predictive value of three transdiagnostic risk variables (anxiety sensitivity, emotion dysregulation, and distress tolerance) in predicting HIV symptom severity, barriers to HIV medication adherence, and viral load among 139 PLWHA (75.5% male, average age = 48.2, 42% African American). In this investigation anxiety sensitivity was shown to be significantly related to HIV symptom severity when examined concurrently with these other variables.…”

Anxiety Sensitivity in Relation to Sleep Quality Among HIV-Infected Individuals

“…One relevant factor in this area is anxiety sensitivity (AS), a cognitive vulnerability defined as the fear of anxiety, its relevant bodily sensations, and its potential negative social, physical, and mental consequences (Taylor et al, 2007). AS has unique relations to sleep disturbances and, among individuals with HIV, specifically, has been linked to greater physiological distress, anxiety, and depression symptoms (Gonzalez, Zvolensky, Parent, Grover, & Hickey, 2012; Gonzalez, Zvolensky, Solomon, & Miller, 2010), suicidality (Capron, Gonzalez, Parent, Zvolensky, & Schmidt, 2012), as well as self-reported HIV symptom severity (Leyro, Vujanovic, & Bonn-Miller, under review). …”

Main and interactive effects of emotion dysregulation and HIV symptom severity on quality of life among persons living with HIV/AIDS

“…The DERS has been used in previous studies using the HIV/AIDS population (Brandt et al, 2013; Leyro, Vujanovic, & Bonn-Miller, 2014). For the current study, internal consistency was excellent (α = 0.92).…”