In the first 2 years of our NIMH-funded 3 year study we have recruited a heterogeneous physically asymptomatic population of over 350 adults at risk for AIDS, assessed their immediate psychological response to HIV antibody testing, randomized them to 3 standardized psychoeducational interventions, and begun comparing entry measures of distress risk behaviors, coping and immune function with scores at 2 and 6 months post- notification. This 5-year renewal will enable us to (1) establish an outreach program to recruit and maintain more intravenous drug users (IVDU); (2) follow our HIV+ and at risk HIV- for longer than 6 months; (3) enter more subjects to achieve adequate sample size for each major risk group and each post-notification intervention; (4) similarly recruit, elsewhere of HIV+ (""""""""known HIV+""""""""); and (5) examine for possible HIV-induced will (Ia); Document the psychobehavioral responses to voluntary HIV antibody testing on physically asymptomatic subjects representing five risk groups: (1) 60 HIV+/ 60 HIV- IVDU. (2) 60 HIV+/60HIV- gay males, (3) 60 HIV+/60HIV- bisexual males (4) 60 HIV+/60 HIV- heterosexuals whose partners are at high risk for HIV-, and (5) 400 heterosexuals whose partners are at relatively lower risk for HIV+; (Ib): Determine for the first 4 risk groups the effectiveness in reducing psychological distress and risk behaviors of 3 post-notification interventions: HIV counseling alone or 6 additional individual weekly stress-prevention training (SPT) sessions or 3 additional weekly SPT sessions imparted by an interactive video program: (II): similarly examine the effectiveness of these 3 interventions for known HIV+' 60 IVDU, 60 gay males, 60 bisexual males and 60 non-IVDU heterosexuals; and (III) longitudinally, compare at 6 month intervals over 3 years the neuropsychological neurological and neurorediographic (MRI) findings of 50 HIV+ and 50 closely-matched HIV- gay/bisexual males enrolled in I or II. Predictor variables assessed at entry on all 720 subjects at high risk for AIDS include (1) HIV serology; (2) clinical ratings of DSM-III-R Axis I/II disorders (SCID/PDE; depression (Hamilton); cognitive capacity (CCSE), and physical symptoms/sighs; and (3) self-report measures of distress (IES, BS1, VAS, STAI); (4) coping, hardiness, attributional styles (ASQ-R), social support (ISEL), life stressors (PERI); (5) risk behaviors, and (6) lymphocyte subsets on 480 HIV+ and 60 comparison HIV-. Outcome variables assessed at 2,6,12,18,24,30 and 36 months alter entry include seroconversion, psychiatric diagnosis, and/or4), psychological distress, coping, risk behaviors, and immunological status (e.g. total T4). This well-established study uniquely, cost-effectively and scientifically addresses critical areas of research targeted by RFPs of the NIMH.

Agency
National Institute of Health (NIH)
Institute
National Institute of Mental Health (NIMH)
Type
Research Project (R01)
Project #
5R01MH042277-05
Application #
3381474
Study Section
MH Acquired Immunodeficiency Syndrome Research Review Committee (MHAZ)
Project Start
1986-09-30
Project End
1992-08-31
Budget Start
1990-09-01
Budget End
1991-08-31
Support Year
5
Fiscal Year
1990
Total Cost
Indirect Cost
Name
Weill Medical College of Cornell University
Department
Type
Schools of Medicine
DUNS #
201373169
City
New York
State
NY
Country
United States
Zip Code
10065
Ferrando, Stephen J; Rabkin, Judith G; Lin, Shu-Hsing et al. (2005) Increase in body cell mass and decrease in wasting are associated with increasing potency of antiretroviral therapy for HIV infection. AIDS Patient Care STDS 19:216-23
Rabkin, Judith G; McElhiney, Martin; Ferrando, Stephen J et al. (2004) Predictors of employment of men with HIV/AIDS: a longitudinal study. Psychosom Med 66:72-8
Rabkin, J G; Ferrando, S J; van Gorp, W et al. (2000) Relationships among apathy, depression, and cognitive impairment in HIV/AIDS. J Neuropsychiatry Clin Neurosci 12:451-7
Sewell, M C; Goggin, K J; Rabkin, J G et al. (2000) Anxiety syndromes and symptoms among men with AIDS: a longitudinal controlled study. Psychosomatics 41:294-300
de Moore, G M; Hennessey, P; Kunz, N M et al. (2000) Kaposi's sarcoma: The Scarlet Letter of AIDS: the psychological effects of a skin disease. Psychosomatics 41:360-3
Rabkin, J G; Ferrando, S J; Lin, S H et al. (2000) Psychological effects of HAART: a 2-year study. Psychosom Med 62:413-22
Evans, S; Ferrando, S J; Rabkin, J G et al. (2000) Health locus of control, distress, and utilization of protease inhibitors among HIV-positive men. J Psychosom Res 49:157-62
Goggin, K; Sewell, M; Ferrando, S et al. (2000) Plans to hasten death among gay men with HIV/AIDS: relationship to psychological adjustment. AIDS Care 12:125-36
Wagner, G J; Ferrando, S J; Rabkin, J G (2000) Psychological and physical health correlates of body cell mass depletion among HIV+ men. J Psychosom Res 49:55-7
Ferrando, S J; Rabkin, J G; Poretsky, L (1999) Dehydroepiandrosterone sulfate (DHEAS) and testosterone: relation to HIV illness stage and progression over one year. J Acquir Immune Defic Syndr 22:146-54

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