Ms. Stout-Shaffer proposes a randomized clinical trial to evaluate the effect of a 12 week training program on relaxation with guided imagery in HIV infected adults. Five hypotheses will be tested: HIV subjects who regularly practice relaxation will exhibit significant improvement in: 1) psychological distress, 2) quality of life, 3) morning and evening salivary cortisol levels, 4) CD4/CD8 ratio, 5) one or more health behaviors. She will also examine viral load in persons who practice relaxation versus those that do not. Thirty subjects will be recruited through the HIV clinic and community based AIDS support groups. Twenty will be randomly assigned to the treatment group, and 10 to the wait-listed controls. Pre-intervention blood samples will be collected during week one of the study, and in week 2, subjects will begin the relaxation training. This will consist of autogenic, centering and progressive muscle relaxation training and standard imagery techniques. Subjects will attend 2 hour training sessions at the GCRC during weeks 2,3,4,6,8,10, and 14, and one home training session during week 4. Subjects will be contacted by phone during weeks 5,7,9,11,12,and 13 for problem solving, education, and support. Psychosocial measures and salivary cortisol samples will be taken at baseline (week 2), and again at 6, 10, and 14 weeks. Practice frequency will be monitored and experimental subjects will have contracted to practice at least 15 minutes 5 days a week for 12 weeks. At week 14, blood samples will again be collected, and the wait-listed controls will start their training program. Control subjects will be scheduled for data collection according to the same schedule. Blood will be analyzed for CD4 and CD8 counts and ratio, and saliva for cortisol levels. The psychosocial measures collected during the relaxation period include the POMS, a social support questionnaire, an HIV medical outcomes measure of quality of life, a symptom checklist, and a health behavior checklist. Data will be analyzed using repeated measures ANOVA, controlling for practice frequency and factors that may affect the autonomic nervous system. She anticipates being able to complete the study in one year. RESEARCH PLAN
