Coping as a multisystem construct associated with pathways mediating HIV-relevant immune function and disease progression

We review psychoneuroimmunological research linking coping with HIV disease progression and its indicators, as well as with viral and host factors that may mediate or contribute to HIV progression. Our perspective on coping broadly encompasses the attempts of multiple mental and biological systems to adapt to changing internal and environmental conditions and to reestablish homeostasis. Accordingly, we discuss studies within four dimensions of coping: cognitive (appraisals, expectancies, and explanatory style), emotional (the Type C coping pattern and related constructs), active-passive strategies and behavior patterns, and physiological (autonomic reactivity and recovery). Finally, we present a model that integrates key studies linking coping with HIV prognostic indicators and clinical disease progression. Based on empirical evidence, the model suggests plausible mechanisms by which coping may be connected to HIV progression/antiprogression factors and immunopathogenesis to affect HIV clinical progression.