Negative affectivity, coping, immune status, and disease progression in HIV infected individuals

The primary goal of the study was to assess the relationship between personality dispositions, coping styles, immune markers, clinical status, and subjective somatic symptoms in a mixed sample of HIV positive individuals. Specifically, the prognostic value of psychological and immunological measures in HIV progression was emphasized. Subjects (n = 104) were recruited from a cohort of 422 HIV positive individuals enrolled in the Oslo HIV Cohort Study. The participants were given self-administered questionnaires assessing behavioral, psychological, and psychosocial variables. Clinical assessment and immunological tests were performed at regular follow-up visits. Clinical status was assessed according to the Centers for Disease Control criteria. The immune markers used were CD4 T cell counts, beta2-microglobulin concentration, serum levels of HIV-1 p24 core protein, and levels of antibodies to core protein. In addition, subjective somatic symptoms were assessed. The results showed that measures of negative affectivity (NA; e.g. anxiety, distress, tension) were consistently related to subjective somatic symptoms and passive-defensive coping style. However, no consistent association between NA measures and immune markers was found. Individuals who developed AIDS in the study period had significantly lower initial CD4 cell counts as well as lower scores on measures of active-problem related coping (e.g. Positive reappraisal, Seeking social support) and passive-defensive coping (i.e. Escape-Avoidance, Self-control). The results suggest (1) that coping styles may merit a specific focus in future research of psychological factors and medical outcomes in HIV infection, and (2) because of associations of NA measures with symptom reports studies of the relationship between e.g. stress, depression and HIV outcome should consider these variables as confounders.