Recent advances in pharmacotherapy that have helped contain the AIDS virus, have dramatically increased the need for psychosocial interventions that can concurrently facilitate drug adherence, promote harm reduction, decrease anxiety and depressed affect, improve quality of life, and explore possibilities for optimizing immune functioning in diverse and often hard to reach populations. These populations include low socioeconomic status minority and/or substance abuse individuals. This 5 year program project continuation would meet these objectives using cognitive-behavioral stress management (CBSM) as the intervention, primarily in Black, Hispanic and non-Hispanic White men and women. Projects 0002 and would examine the effects of CBSM in symptomatic HIV+ gay men and in women, respectively, as a function of psychosocial, endocrine, immune and health status variables. Because chronic physiological arousal may adversely impact immune function and disease progression and because we have found that HIV+ versus HIV- individuals differ in their endocrine and immune responses to acute stressors, Project 0002 will conduct pre- versus post-CBSM psychophysiological laboratory studies to examine the effects that the CBSM program and the implementation of trained relaxation responses have on acute stress responses in HIV+ individuals. The projects will each be supported by administrative, health, psychosocial, endocrinology, immunology, and data management and statistics core units.
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