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Objective: In an era of highly active anti-retroviral therapies, the authors needed to confirm previous findings showing that stress and depression have an impact on HIV disease progression. The goal of the current study was to examine the effects of lifetime trauma, recent stressful events, and depression on all-cause and AIDS-related mortality among HIV-infected men and women. The authors hypothesized that these psychosocial variables would predict significantly faster HIV-specific and all-cause mortality. Method: The authors consecutively sampled HIV-infected men and women who received care at one of eight infectious diseases clinics in five Southeastern states. The sample included 490 patients who were followed by interview for 27 months and followed with their medical records for up to 41 months. Results: There were 29 deaths; 16 were AIDS-related. More lifetime trauma and antigenic marker on helper/inducer T cells (CD4) <200 significantly predicted faster all-cause and AIDS-related mortality. For those at or above the median in trauma, the all-cause death rate was 3.54 per 100 person-years, compared to 1.72 for those below the median. For those at or above the median in trauma, the AIDS-related death rate was 2.13 per 100 person-years, compared to 0.77 for those below the median. Depressive symptoms and higher baseline viral load were significantly related to greater risk of AIDS-related mortality. Conclusions: Further research is needed to determine if interventions to address trauma and depression can modify these detrimental effects on HIV. [ABSTRACT FROM AUTHOR]

Examines the effects of stressful events, depressive symptoms, social support, coping methods and cortisol levels on the progression of HIV-1 infection in homosexual male subjects. Use of Cox regression models with time-dependent covariates; Measurement of variables and their effect on AIDS progression.

Presents a study testing the hypothesis that stressful life events accelerate the course of HIV disease. Analysis of the time of the first disease progression using a proportional hazard survival method; Prediction of the degree of disease progression by severe life stress using the proportional odds logistic model for analysis.

Examines the relationship of the somatic symptoms fatigue and insomnia with indicators of both psychiatric disturbance and HIV disease severity. Standardized tests to determine neuropsychological function ratings; Association of complaints of fatigue and insomnia with dysphoric mood, major depression, and other non-HIV-related symptoms of major depression.

Examines how stressful events and depression may affect key parameters of cellular immunity in subjects with and without HIV infection. Reductions in natural killer (NT) and cytotoxic T effector cell populations; Relation between stress and immune system measures in HIV-negative men.

Describes the coping strategies used by symptomatic HIV-positive homosexual men, examines the relationship of copying to dysphoria and self-esteem and explores how race and social support correlate with coping. Method; The Coping in Health and Illness Project questionnaire with a modification of the COPE; The Hamilton Rating Scale for Depression; Subjects; Procedure; Measures; Statistical methods; Results; Discussion.