As HIV infection has shifted from being an imminently terminal illness to a challenging chronic illness, it has become increasingly important to know how people with HIV maintain their well being over time. The maintenance of well being is in itself an important goal, but well being is also important because it is a key to healthcare adherence, economic productivity, social satisfaction, and over-all quality of life. Previous research on coping with HIV is limited in that it is largely atheoretical; focuses on negative outcomes such as distress, ignoring positive outcomes such as well-being; and tends to be cross-sectional. This pilot study proposes to apply stress and copy theory (Folkman, 1997; Lazarus & Folkman, 1984) to longitudinal data in order to (1) develop a typology of HIV-associated stress and coping processes from two years of bimonthly narratives of 57 HIV+ men, and (2) examine the association between the typology and subsequent quantitative measures of coping, positive and negative psychological states, HIV-related symptoms, and CD4 cells at 24, 36, 48, and 60 months after entry into the study. The study participants were recruited as a comparison group of HIV+ non-caregiving men in a study of the caregiving partners of men with AIDS (MH4405, MH49985, Susan Folkman, Principle Investigator). Using an interpretive phenomenological approach, investigators plan to develop a typology of HIV-associated stress and coping processes through a three-step process of coding narratives, doing case studies, and performing a cross-case analysis. We will examine the association between the typology and quantitative measures of coping, positive and negative psychological states, and HIV-related symptoms. Demographics, use of anti-retrovirals, and length of time of known HIV serostatus treatment will be used as control variables. The 8 sub-scales from the Ways of Coping Questionnaire will be used as validation variables.
