In order to determine psychological factors that may be protective of health and/or related to survival in AIDS, this study proposes to compare three groups on psychological measures: 1) long-term survivors of AIDS; 2) the rare HIV positive people who have low CD4 counts (less than or equal to 50) and have always been clinically asymptomatic (asymptomatic low CD4 group; no CDC 1993 category B or C symptoms); and 3) an early """"""""numerical"""""""" AIDS group (HIV positive people with CD4 counts between 150-200 at entry to the study who are clinically asymptomatic and have not ever had category C symptoms). Study I compares the groups cross-sectionally in order to discern any psychological differences that the long term survivor group and asymptomatic low CD4 group have, especially as compared with the early numerical AIDS group. Study II follows the early numerical AIDS group longitudinally to determine whether: 1) these psychological characteristics developed as a result of continued survival or asymptomatic status (i.e., the chicken-egg problem); 2) the psychological characteristics predict the development of symptoms and/or death (most of this group are expected to become ill and many to die within 3 years); and 3) the psychological changes precede or are a result of health status changes (related to number 1, also the chicken-egg question). The major psychological variables to be assessed through interview and questionnaire include: coping style, life involvement, communication skills (emotional expression, assertiveness), social support, beliefs (self-efficacy, optimism, fatalism), distress, and approach to health care (doctor-patient relationship, taking responsibility for health, keeping up with medical information, etc.). A model is proposed and will be tested by which the impact of AIDS and stressors may be modulated by resources and individual capacities (""""""""trait"""""""" characteristics such as assertiveness, optimism, emotional expression) and behaviors (such as coping, keeping up with medical information) to affect health care, social isolation, depression, and sense of purpose in life and, thus, have an impact on morbidity and longevity. The study will be conducted at two sites, The University of Miami and the University of California at Los Angeles, to ensure an adequate number of the unusual people who comprise Groups 1 and 2.

Agency
National Institute of Health (NIH)
Institute
National Institute of Mental Health (NIMH)
Type
Research Project (R01)
Project #
5R01MH053791-02
Application #
2416095
Study Section
Psychobiological, Biological, and Neurosciences Subcommittee (MHAI)
Project Start
1996-09-30
Project End
2001-04-30
Budget Start
1997-06-01
Budget End
1998-04-30
Support Year
2
Fiscal Year
1997
Total Cost
Indirect Cost
Name
University of Miami Coral Gables
Department
Psychology
Type
Schools of Arts and Sciences
DUNS #
City
Coral Gables
State
FL
Country
United States
Zip Code
33146
Ironson, Gail; Henry, Sarah M; Gonzalez, Brian D (2017) Impact of stressful death or divorce in people with HIV: A prospective examination and the buffering effects of religious coping and social support. J Health Psychol :1359105317726151
Ironson, Gail; Fitch, Calvin; Stuetzle, Rick (2017) Depression and Survival in a 17-Year Longitudinal Study of People With HIV: Moderating Effects of Race and Education. Psychosom Med 79:749-756
Kremer, Heidemarie; Ironson, Gail; Kaplan, Lauren et al. (2015) Spiritual coping predicts CD4-cell preservation and undetectable viral load over four years. AIDS Care 27:71-9
Ironson, G; O'Cleirigh, C; Kumar, M et al. (2015) Psychosocial and Neurohormonal Predictors of HIV Disease Progression (CD4 Cells and Viral Load): A 4 Year Prospective Study. AIDS Behav 19:1388-97
Kremer, Heidemarie; Ironson, Gail (2014) Longitudinal spiritual coping with trauma in people with HIV: implications for health care. AIDS Patient Care STDS 28:144-54
Ruffin, Rachel; Ironson, Gail; Fletcher, May Ann et al. (2012) Health locus of control beliefs and healthy survival with AIDS. Int J Behav Med 19:512-7
Ironson, Gail; Stuetzle, Rick; Ironson, Dale et al. (2011) View of God as benevolent and forgiving or punishing and judgmental predicts HIV disease progression. J Behav Med 34:414-25
Ironson, Gail; Kremer, Heidemarie (2009) Spiritual transformation, psychological well-being, health, and survival in people with HIV. Int J Psychiatry Med 39:263-81
Kremer, Heidemarie; Ironson, Gail; Porr, Martina (2009) Spiritual and mind-body beliefs as barriers and motivators to HIV-treatment decision-making and medication adherence? A qualitative study. AIDS Patient Care STDS 23:127-34
Kremer, H; Ironson, G; Kaplan, L (2009) The fork in the road: HIV as a potential positive turning point and the role of spirituality. AIDS Care 21:368-77

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