Psycho-immunology and HIV infection : biopsychosocial determinants of distress, immunological parameters, and disease progression in homosexual men infected with human immunodeficiency virus-1

Subjects who have tested positive for the presence of antibodies against Human Immunodeficiency Virus Type I (further abbreviated as HIV), have to live with a lifethreatening infection. At present, no definite medical cure is available that prevents progression of HIV infection. Therefore, knowledge of being infected with this virus puts a heavy burden on one's coping capabilities. Although some subjects find a way to live with their HIV infection, others have great difficulties in adjusting to it and may suffer from psychological distress. Whether or not HIV-infected subjects develop psychological distress is determined by several factors. These include for instance the experience of other stressful life events, the type of coping style that is used, and the quality of the social network. However, little is known about the relative importance of each of these variables and the way they interact in predicting distress levels. HIV -infected individuals may benefit from psychosocial interventions that aim at increasing social support and improving coping strategies. Although several types of psychosocial intervention may be effective, the relative effectiveness of different psychotherapeutic intervention strategies is unknown. We investigated factors that determine the level of distress and the effectiveness of two different psychosocial interventions in decreasing distress levels in asymptomatic and early symptomatic HIV-infected homosexual men. These studies are described in Part L In Part IT studies pertaining to the associations between psychosocial factors and progression of HIV infection are described. The length of the period until the development of Acquired Immunodeficiency Syndrome (AIDS) varies considerably among individuals and it is hypothesized that some of the variation is due to psychosocial factors. These factors may include stressful life events, psychological distress, coping styles and social support. In the event that psychosocial factors have an influence, psychosocial interventions may slow down the rate of progression, and enhance the effectiveness of medical treatments. Studying the effect of psychosocial factors on disease progression is therefore of clinical relevance. It is of theoretical relevance because insights are gained into psychoneuroimmunological relationships in a virologically and immunologically mediated disease.