This 5 year project examines the effects of bereavement and its predicted mediators -- other life stressor frequency, social support, and copying style -- on psychological, limbic-hypothalamic-pituitary-adrenal (LHPA) axis, immunological, physical health and virological outcomes in bereaved and non-bereaved HIV+ and HIV+ women. 180 women will be recruited; 60 non- bereaved HIV+ women (nHIV+ = 120) and 30 bereaved and 30 non-bereaved HIV- women (nHIV- =60). The bereaved will have lost a significant other to AIDS within the prior 6 months; all will be assessed at baseline and every 6 months for 2 years on psychological distress, increased LHPA axis measures (cortisol --controlling for CBG level, ratio with DHEA and DHEA-S, and 17 beta-estradiol level; ACTH; CRH) decreased immunological measures (lymphocyte proliferative responses to PHA and pokeweed, NKCC), decreased physical health status (laboratory progression markers; 1993 CDC stage change;' progression to AIDS), and increased virological measures (free p24 antigen level; plasma HIV RNA copy number by PCR), both cross-sectionally and longitudinally over a two year follow-up period. Bereavement will retain, such effects, controlling for other known potential psychosocial mediators of such associations, using a stressor-support-coping model described previously. This model will predict level of a changes in psychological distress, immunological measures, physical health status, and virological measures. Controls will be time since bereavement, number/type of losses, psychopathology (Axes I and II), quality/length of relationship.
