The follow-up study will identify psychosocial and demographic predictors of long-term recovery from bereavement in a unique cohort of 300 HIV+ and HIV-partners of men with AIDS. This cohort has been recruited for an ongoing prospective study of gay men who are the caregiving partners of men with AIDS. The increase in psychological distress, morbidity, and mortality among close relations following bereavement has been amply documented. Gay men whose partners die because of AIDS are particularly vulnerable to deleterious psychological and physical effects because of special characteristics of AIDS-related bereavement. By July 1, 1992 we will have a cohort of at least 93 HIV+ and 136 HIV-bereaved men (a total of 229) who will have been followed from prior to their partner's death. By following this cohort an additional three years, we will have the opportunity to identify pre- bereavement predictors of long-term recovery from bereavement. In addition to the 300 caregiving partners, the ongoing study includes a comparison group of 60 HIV+ men with healthy partners. This comparison group allows us to determine the extent to which being HIV+ affects successful recovery from bereavement and increases vulnerability to adverse psychological, social, and physical effects due to bereavement. Recovery is defined in terms of psychological status, physical health, and social functioning. The focus of the study is on individual differences in patterns of recovery over time. This follow-up study will determine: A) the extent to which short-term psychological response to bereavement predicts recovery up to 4.5 years post bereavement; (B) pre-bereavement and post-bereavement demographic and psychosocial variables that predict long-term psychological, physical, and social recovery from bereavement; and (C) the extent to which long-term recovery is affected by HIV serostatus and HIV disease progression. In addition, based on our current findings, we expect to have a sample of 18 to 57 men who actively participate in hastening their partner's death through euthanasia or assisted suicide. We will describe the effects on the bereaved survivor's recovery of hastening a partner's death through euthanasia or assisted suicide. A cognitive theory of stress and coping provides the framework for the study. Subjects will be assessed semiannually for three years. Assessments will include clinical evaluations of mental health; physical examinations and CD4 cell counts; and self-reports of positive and negative moods, stress (major life events, daily hassles, and background bereavement), coping, social support and conflict, quality of partner relationship, optimism, acceptance by family, work functioning, and social integration.
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