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This study examined how the expression of positive and negative affect words and word tense in autobiographical narratives of 98 HIV+ women, predominantly African American, predicted undetectable HIV viral load (UDVL), CD4+ cells/mm3 counts and antiretroviral therapy medication (ART) adherence assessed concurrently (T1) and at 3 to 9-month follow-up (T2). Logistic regressions revealed that higher past tense words predicted worse odds of UDVL, CD4+ cells/mm3 above 350 at T1, and worse odds of 95% ART adherence at T2. However, using both high past tense words and high positive affect words predicted better odds of CD4+ cells/mm3 > 350 at T2. Higher future tense words predicted better odds of CD4+ cells/mm3 > 350 at T1. Additionally, using both high present tense words and negative affect words predicted better odds of UDVL at T1. These findings provide preliminary evidence that the quality of affect expression significantly interacts with temporal context to relate to the health of women with HIV. [ABSTRACT FROM AUTHOR]

Women with HIV in the United States cope with multiple traumas that influence adherence to antiretroviral therapy (ART) and well-being. Narrative themes from three life turning points and a projective story task were compared for two groups of women with HIV (HIV well-managed vs. HIV not well-managed, matched on demographics and narrative word count) to understand predictors of successful outcomes. The well-managed group (n= 10) was virally suppressed and reported ≥95% ART adherence; the not well-managed group (n= 10) had detectable viral load and reported <95% ART adherence. Women were predominantly African American with low socioeconomic status and averaged 46.51 years. A three-stage coding process (with coders blind to group status in stages 1 and 2) involved (1) line by line thematic analyses that generated 155 subthemes reflecting six content areas (interpersonal relationships; culture and community; sense of self; relationship to past, present, and future experiences; self-care; and motivators for change); (2) absence/presence of the 155 subthemes was compared for the two groups; the frequency of 37 subthemes was found to significantly differ; and (3) the 37 differentiating subthemes were conceptually integrated, revealing that the well-managed group's narratives more frequently reflected (a) mutuality (growth-fostering relationships involving reciprocal care and empathy); (b) self-awareness (recognition of personal strengths and weaknesses and multiple factors contributing to life choices and trajectories); and (c) self-efficacy (active coping, self-advocacy, and utilizing resources). Implications for treatment and interconnections among themes are discussed, emphasizing the factors that enable women to care for themselves and others. [ABSTRACT FROM AUTHOR]