In the first 2 years of our NIMH-funded 3 year study we have recruited a heterogeneous physically asymptomatic population of over 350 adults at risk for AIDS, assessed their immediate psychological response to HIV antibody testing, randomized them to 3 standardized psychoeducational interventions, and begun comparing entry measures of distress risk behaviors, coping and immune function with scores at 2 and 6 months post- notification. This 5-year renewal will enable us to (1) establish an outreach program to recruit and maintain more intravenous drug users (IVDU); (2) follow our HIV+ and at risk HIV- for longer than 6 months; (3) enter more subjects to achieve adequate sample size for each major risk group and each post-notification intervention; (4) similarly recruit, elsewhere of HIV+ (""""""""known HIV+""""""""); and (5) examine for possible HIV-induced will (Ia); Document the psychobehavioral responses to voluntary HIV antibody testing on physically asymptomatic subjects representing five risk groups: (1) 60 HIV+/ 60 HIV- IVDU. (2) 60 HIV+/60HIV- gay males, (3) 60 HIV+/60HIV- bisexual males (4) 60 HIV+/60 HIV- heterosexuals whose partners are at high risk for HIV-, and (5) 400 heterosexuals whose partners are at relatively lower risk for HIV+; (Ib): Determine for the first 4 risk groups the effectiveness in reducing psychological distress and risk behaviors of 3 post-notification interventions: HIV counseling alone or 6 additional individual weekly stress-prevention training (SPT) sessions or 3 additional weekly SPT sessions imparted by an interactive video program: (II): similarly examine the effectiveness of these 3 interventions for known HIV+' 60 IVDU, 60 gay males, 60 bisexual males and 60 non-IVDU heterosexuals; and (III) longitudinally, compare at 6 month intervals over 3 years the neuropsychological neurological and neurorediographic (MRI) findings of 50 HIV+ and 50 closely-matched HIV- gay/bisexual males enrolled in I or II. Predictor variables assessed at entry on all 720 subjects at high risk for AIDS include (1) HIV serology; (2) clinical ratings of DSM-III-R Axis I/II disorders (SCID/PDE; depression (Hamilton); cognitive capacity (CCSE), and physical symptoms/sighs; and (3) self-report measures of distress (IES, BS1, VAS, STAI); (4) coping, hardiness, attributional styles (ASQ-R), social support (ISEL), life stressors (PERI); (5) risk behaviors, and (6) lymphocyte subsets on 480 HIV+ and 60 comparison HIV-. Outcome variables assessed at 2,6,12,18,24,30 and 36 months alter entry include seroconversion, psychiatric diagnosis, and/or4), psychological distress, coping, risk behaviors, and immunological status (e.g. total T4). This well-established study uniquely, cost-effectively and scientifically addresses critical areas of research targeted by RFPs of the NIMH.

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National Institute of Mental Health (NIMH)
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MH Acquired Immunodeficiency Syndrome Research Review Committee (MHAZ)
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Weill Medical College of Cornell University
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New York
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Ferrando, Stephen J; Rabkin, Judith G; Lin, Shu-Hsing et al. (2005) Increase in body cell mass and decrease in wasting are associated with increasing potency of antiretroviral therapy for HIV infection. AIDS Patient Care STDS 19:216-23
Rabkin, Judith G; McElhiney, Martin; Ferrando, Stephen J et al. (2004) Predictors of employment of men with HIV/AIDS: a longitudinal study. Psychosom Med 66:72-8
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de Moore, G M; Hennessey, P; Kunz, N M et al. (2000) Kaposi's sarcoma: The Scarlet Letter of AIDS: the psychological effects of a skin disease. Psychosomatics 41:360-3
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Evans, S; Ferrando, S J; Rabkin, J G et al. (2000) Health locus of control, distress, and utilization of protease inhibitors among HIV-positive men. J Psychosom Res 49:157-62
Goggin, K; Sewell, M; Ferrando, S et al. (2000) Plans to hasten death among gay men with HIV/AIDS: relationship to psychological adjustment. AIDS Care 12:125-36
Wagner, G J; Ferrando, S J; Rabkin, J G (2000) Psychological and physical health correlates of body cell mass depletion among HIV+ men. J Psychosom Res 49:55-7
Ferrando, S J; Rabkin, J G; Poretsky, L (1999) Dehydroepiandrosterone sulfate (DHEAS) and testosterone: relation to HIV illness stage and progression over one year. J Acquir Immune Defic Syndr 22:146-54

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