Chronic Stress Effects of HIV Infection in Hemophiliacs

Dew, Mary

Abstract

Approximately 75% of all hemophiliacs are estimated to be infected by human immunodeficiency virus (HIV), the primary etiologic agent of acquired immunodeficiency syndrome (AIDS). Despite assertions that the emotional costs of protracted coping with the uncertainty of developing AIDS are high, there has been no systematic investigation of the mental health consequences of HIV infection among hemophiliacs. Moreover, little is known about the degree to which hemophiliacs' coping styles, social supports, etc. might ameliorate or aggravate the stress effects of HIV infection. Chronic stress resulting from infection may not only induce mental distress, but exacerbate physical symptoms of hemophilia. The proposed case-comparison group study seeks to (a) examine the relationship of HIV infection to psychiatric symptomatology and hemorrhagic manifestations of hemophilia and (b) evaluate the degree to which psychosocial variables influence these relationships. Adult hemophiliacs who are seropositive for HIV antibodies will be compared to adults who are not infected but are similar to infected individuals in the severity of their hemophilia. The entire population of 113 western Pennsylvania hemophiliacs, of whom 52 are seropositive, will be contacted for study. Interviews will be conducted to assess current psychiatric symptomatology; current physical health; personal psychosocial characteristics (perceptions and beliefs about AIDS, coping styles); environmental psychosocial characteristics (recent life events, social support, spouse's psychiatric symptomatology); and predispositional psychosocial characteristics (sociodemographic data, mental health history). In addition, in order to provide baseline health data prior to the AIDS epidemic, medical records will be reviewed. Psychiatric symptom data collected from a subsample of 29 of the 113 individuals prior to HIV infection onset will also be retrieved. An ultimate aim of the analyses is to identify critical variables in the chronic stress process resulting from HIV infection and thereby develop an empirical model to be tested in a subsequent longitudinal investigation of health changes occurring in the proposed study cohort.