Coping responses to HIV-1 serostatus notification predict concurrent and prospective immunologic status

We prospectively related coping strategies and immunologic measures in HIV-1 seropositive and seronegative gay men over the 1-year period following notification of their antibody test results. First, we related 18 asymptomatic HIV-1 seropositive men's coping responses to antibody status notification with concurrently measured phenotypic and functional immunologic markers. Repeated-measures ANOVAs indicated that seropositive subjects scoring above the median on postnotification disengagement coping strategies (denial, behavioural disengagement, mental disengagement) had significantly lower concurrently measured T-helper/suppressor (CD4/CD8) cell ratios, T-inducer subset (CD4+CD45RA+) percentage values, and proliferative responses to phytohemagglutinin (PHA) than subjects scoring below the median on these scales. Disengagement coping responses also predicted 1-year follow-up immune markers; greater disengagement predicted poorer lymphocyte responsivity to PHA. Thirty sociodemographically-equivalent HIV-1 seronegative gay men showed the opposite pattern such that greater disengagement coping predicted significantly greater lymphocyte responsivity to PHA and larger CD4+CD45RA+ percentage values at 1-year follow-up. Together these preliminary findings suggested that: (a) coping strategies relate to immunologic status differentially for infected and non-infected risk group members; (b) strategies that distract seropositive individuals from the stress of infectivity are related to more impairment on some immunologic markers; and (c) these relationships occur concurrently and some appear to persist over as long as a 12-month period.