Balbin EG, Ironson GH, Solomon GF. Stress and coping: the psychoneuroimmunology of HIV/AIDS.
BAILLIERE'S BEST PRACTICE & RESEARCH. CLINICAL ENDOCRINOLOGY & METABOLISM 1999;
13:615-33. [PMID:
10903818 DOI:
10.1053/beem.1999.0047]
[Citation(s) in RCA: 33] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
A considerable body of evidence, reviewed in this chapter, suggests that psychosocial factors play an important role in progression of HIV infection, its morbidity and mortality. Psychosocial influences relating to faster disease progression include life-event stress, sustained depression, denial/avoidance coping, concealment of gay identity (unless one is rejection-sensitive), and negative expectancies. Conversely, protective psychosocial factors include active coping, finding new meaning, and stress management. In studying long survivors of HIV/AIDS, our group has found protective effects on health of life involvement, collaborative relationship with doctor, emotional expression, depression (conversely), and perceived stress (conversely). Reviewed and discussed are psychoneuroimmunological pathways by which immune and neuroendocrine mechanisms might link psychosocial factors with health and long survival. Finally, biological factors are also a major determinant of disease progression and include genetics and age of the host, viral strain and virulence, medication and several immune response factors on which psychosocial influences could impact.
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