Cognitive Behavioral Stress Management (CBSM) can change stressor appraisals and build coping resources; modulate the output of sympathetic nervous system, Hypothalamic Pituitary Adrenal, and Hypothalamic Pituitary Gonadal hormones; and help normalize immunologic status in different HIV+ populations. Recent work suggests that these psychosocial and physiologic changes may influence quality of life and possibly disease course. The proposed 5-year project will directly address these issues in 200 HIV-infected women who are co-infected with Human Papillomavirus (HPV), the putative etiologic virus in cervical carcinoma. We will (a) evaluate the effects of CBSM intervention on quality of life (negative affect, positive growth, fatigue and physical functioning, sexuality) and physical health changes (biopsy-determined squamous fatigue and physical functioning, sexuality) and physical health changes (biopsy-determined squamous intraepithelial lesions [SIL] and opportunistic infections [E.G. herpesvirus outbreaks]; and (b) examine the hypothesized psycho-biological mediators (psychosocial endocrine, and immunologic changes) of intervention effects observed. We will address the psychosocial (quality of life indicators, intervention process measures), virologic (HPV type), immunologic status (natural killer cell cytotoxicity and lymphocyte phenotypes for T-helper-inducer cells [CD3+CD4+, T-suppressor-cytotoxic cells [CD3+CD8+] and natural killer cells [CD3-CD56+]) and health status (SIL incidence and severity, herpes simplex virus) in HIV+HPV+ women at study entry (T1) and then randomize women to either a 10-week CBSM intervention or a one-day CBSM seminar. We will re-assess psychosocial, immunologic and physical health variables after the intervention period (T2) and again at a 6-month (T3) and 12-month (T4) follow-up. We will examine 5 hypothesized CBSM process variables as mediators of its effects on Quality of Life including Cognitive Appraisals, Coping Self-Efficacy, Emotional Processing, Social Support and Physiologic Arousal (using 24- hour urinary catecholamines and cortisol). We will examine 3 hypothesized mediators of physical health changes during the 12-month follow-up including Health Behaviors (medication adherence, health care utilization, smoking, unprotected ex, and substance use). Immunologic Status (NKCC, CD3+CD4+, CD3+CD8+, CD3-CD56+), and Reproductive Hormones (DHEA-S, testosterone, estradiol).

Agency
National Institute of Health (NIH)
Institute
National Cancer Institute (NCI)
Type
Specialized Center (P50)
Project #
5P50CA084944-03
Application #
6500748
Study Section
Special Emphasis Panel (ZRG1)
Project Start
2001-09-01
Project End
2002-08-31
Budget Start
Budget End
Support Year
3
Fiscal Year
2001
Total Cost
Indirect Cost
Name
University of Miami Coral Gables
Department
Type
DUNS #
City
Coral Gables
State
FL
Country
United States
Zip Code
33146
Jensen, Sally E; Pereira, Deidre B; Whitehead, Nicole et al. (2013) Cognitive-behavioral stress management and psychological well-being in HIV+ racial/ethnic minority women with human papillomavirus. Health Psychol 32:227-30
Cruess, Dean G; Benedict, Catherine; Lattie, Emily G et al. (2013) Millon Behavioral Medicine Diagnostic (MBMD) Predicts Health-Related Quality of Life (HrQoL) over time among men treated for localized prostate cancer. J Pers Assess 95:54-61
Traeger, Lara; Penedo, Frank J; Benedict, Catherine et al. (2013) Identifying how and for whom cognitive-behavioral stress management improves emotional well-being among recent prostate cancer survivors. Psychooncology 22:250-9
Lopez, Corina R; Antoni, Michael H; Pereira, Deirdre et al. (2013) Stress Management, Depression and Immune Status in Lower Income Racial/Ethnic Minority Women Co-infected with HIV and HPV. J Appl Biobehav Res 18:37-57
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Zhou, Eric S; Penedo, Frank J; Bustillo, Natalie E et al. (2010) Longitudinal effects of social support and adaptive coping on the emotional well-being of survivors of localized prostate cancer. J Support Oncol 8:196-201
Zhou, Eric S; Penedo, Frank J; Lewis, John E et al. (2010) Perceived stress mediates the effects of social support on health-related quality of life among men treated for localized prostate cancer. J Psychosom Res 69:587-90
Dodd, Stacy M; Pereira, Deidre B; Marion, Ilona et al. (2009) Depressive symptoms and cervical neoplasia in HIV+ low-income minority women with human papillomavirus infection. Int J Behav Med 16:181-8
Marion, Ilona; Antoni, Michael; Pereira, Deidre et al. (2009) Distress, sleep difficulty, and fatigue in women co-infected with HIV and HPV. Behav Sleep Med 7:180-93
Traeger, Lara; Penedo, Frank J; Gonzalez, Jeffrey S et al. (2009) Illness perceptions and emotional well-being in men treated for localized prostate cancer. J Psychosom Res 67:389-97

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