This is a prospective study of the natural history of bereavement among HIV+ caregiving partners of persons with AIDS. This research will increase understanding of the processes through which major life stress affects mental and physical health and provide information that is needed to design interventions to help persons who are HIV+ maintain their mental and physical health. The research has two major aims: 1) To evaluate the effects of bereavement on the mental and physical health of HIV+ men, controlling for the stage of their HIV infection and their neuropsychological and psychiatric status; (2) To identify stress, coping, and social support processes that influence these effects, including (a) processes that explain declines in mental and physical health and (b) processes that contribute to the maintenance of mental and physical health during caregiving and bereavement. 618 subjects will be assessed bi-monthly for two years. Subjects include 281 HIV+ caregivers, of whom approximately 56 will become bereaved during the study and comprise the HIV+ bereaved group; 281 HIV- caregivers, of whom approximately 56 will become bereaved during the study and form the HIV- bereaved group; and 56 HIV+ noncaregivers. The extent to which effects observed in the HIV+ bereaved group are due to the death of the partner over and above temporal factors, seropositivity, and caregiving will be evaluated through comparisons with the nonbereaved HIV+ caregivers, the HIV- bereaved caregivers, and the HIV+ noncaregivers. Repeated assessments will be made of psychiatric and neuropsychological status: physical health; stress, coping, and social support; and anxiety, depression and positive states of mind in order to describe changes in these variables and the relationships among them over time.
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