BEHAVIORAL MANAGEMENT AND STRESS RESPONSES IN HIV-1

Project: Research project

Description

The objective of this 5 yr program project is to extend findings of our
previous NIMH supported studies of responses to psychological stressors
and their attenuation by behavioral interventions in HIV-1+ gay men. Our
previous research documented that changes in affect, endocrine and/or
immune function occur in response to psychological stressors such as
anticipation or actual diagnosis of HIV status and that responses to
diagnosis in HIV+ men can be attenuated by aerobic exercise of cognitive
behavioral stress management (CBSM). Project 1 would analyze
cardiovascular, endocrine and immunologic reactivity and recovery from
acute stressors by: (a) moving our focus from correlational field
observations to controlled laboratory manipulation; and (b) extending our
previous observations on HIV- and asymptomatic HIV+ White-American gay
men to African- and Hispanic-Americans, to symptomatic HIV-1 infected but
pre-AIDS (WHO Stage 3B) individuals and to women. Thus, the project
would examine autonomic, neuroendocrine and immune responses to an
evaluative speech stressor in 306 subjects using a 3 (ethnicity) x 2
(gender) x 3 (HIV status) design. Project 2 would also extend our
previous research by examining the effects of a 10 week CBSM group
intervention and 6 month post-maintenance program on 100 Hispanic- and
100 nonHispanic White-American WHO Stage 3B gay men randomized into the
CBSM intervention condition or an assessment only control condition. The
CBSM intervention is designed to enhance psychological adjustments to
symptomatic HIV-1 infection and reduce sexual risk and substance use
behaviors by teaching anxiety reduction and self-management techniques,
enhancing interpersonal coping skills and increasing social support. The
maintenance program combines group support and reinforcement of treatment
adherence by using well-documented relapse prevention strategies.
Psychological, endocrine and immune measures would be assessed at study
entry, immediately after the 10 wk intervention period, and after a 6
month maintenance period. Project 3 would extend our previous research
in which we found that moderate aerobic exercise prior to HIV-1 diagnosis
lowered self-report levels of distress following news of seropositivity.
The proposed project would extend our research conducted on asymptomatic
HIV+ gay White men to WHO Stage 3B African- and nonHispanic White-
American men and women coping with HIV-1 related symptoms and stressors.
Relapse prevention strategies will be used to assess feasibility of
aerobic exercise as a long-term intervention in symptomatic HIV-1
infection. The project would randomize 176 men (88 African-American, 88
nonHispanic White-American) and 88 women to either the intervention
condition or an assessment-only control condition and would conduct
aerobic fitness, psychosocial, endocrine and immune assessments at study
entry as well as 3- and 12-months post entry. Cross-project analyses
will be conducted on psychosocial, psychiatric, endocrine and immune
data.
StatusFinished
Effective start/end date2/1/9312/31/04

Funding

  • National Institutes of Health
  • National Institutes of Health
  • National Institutes of Health
  • National Institutes of Health
  • National Institutes of Health
  • National Institutes of Health
  • National Institutes of Health
  • National Institutes of Health: $1,405,290.00
  • National Institutes of Health
  • National Institutes of Health
  • National Institutes of Health
  • National Institutes of Health
  • National Institutes of Health
  • National Institutes of Health
  • National Institutes of Health: $128,649.00
  • National Institutes of Health
  • National Institutes of Health
  • National Institutes of Health
  • National Institutes of Health
  • National Institutes of Health
  • National Institutes of Health
  • National Institutes of Health
  • National Institutes of Health
  • National Institutes of Health: $3,046,633.00
  • National Institutes of Health
  • National Institutes of Health
  • National Institutes of Health
  • National Institutes of Health
  • National Institutes of Health
  • National Institutes of Health
  • National Institutes of Health
  • National Institutes of Health
  • National Institutes of Health
  • National Institutes of Health
  • National Institutes of Health
  • National Institutes of Health
  • National Institutes of Health
  • National Institutes of Health
  • National Institutes of Health
  • National Institutes of Health
  • National Institutes of Health
  • National Institutes of Health
  • National Institutes of Health
  • National Institutes of Health
  • National Institutes of Health
  • National Institutes of Health
  • National Institutes of Health: $2,649,825.00
  • National Institutes of Health: $1,308,128.00
  • National Institutes of Health
  • National Institutes of Health: $2,672,234.00
  • National Institutes of Health
  • National Institutes of Health
  • National Institutes of Health
  • National Institutes of Health
  • National Institutes of Health
  • National Institutes of Health
  • National Institutes of Health: $2,661,610.00
  • National Institutes of Health: $49,941.00
  • National Institutes of Health
  • National Institutes of Health

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HIV
HIV-1
Acquired Immunodeficiency Syndrome
Hispanic Americans
Allergy and Immunology
Psychology
African Americans
Endocrinology
Exercise
Secondary Prevention
Catecholamines
National Institute of Mental Health (U.S.)
Maintenance
Hydrocortisone
Research
Molecular Biology
Viral Load
HIV Infections
Self Care
Social Support

ASJC

  • Medicine(all)