The AIDS count for the end of 1992 indicates that AIDS was the leading cause of death for men between the ages of 25 and 44; and the fourth leading cause of death for women in the same age bracket (CDC, 1994). Auerbach, et. al. (1994) address the bidirectional relationship between psychosocial factors and HIV infection, indicating that the relationship may influence disease progression and the ability to effectively treat related symptoms. They note that previous research can be divided into two types, psychoneuroimmunology (the study of how mental states might modify immune defenses and even viral replication within the immune system) and psychosocial research on coping and care giving. However, much of the research in both these areas has focused primarily on gay white men. Yet, the current raising spread of HIV in this country is among women and men of color and young people, without strict regard to their states sexual orientation.
The aim of this study is to investigate the impact of specific supports in the home and treatment environment of persons from different ethnocultural and economic backgrounds who are HIV-positive to determine if these variables make a significant difference in slowing the decline in health status associated with HIV/AIDS. The subjects are 300 Patients age 12 and over, attending the King/Drew OASIS Outpatient Clinic. They will be surveyed for social support measures in the home environment and social network support measures in the medical treatment they receive. The surveys will again be completed at 3, 6, 12, and 24 months following baseline. These measures will be examined for their impact on the health outcome measures of medication compliance, rate of decrease of T-4 helper cells, number of inpatient hospital days and emotional response to health status. It is anticipated that the presence of positive social supports in the home setting and increased network coordination of medical care will be linked to greater medication compliance, a slower rate of decrease in T-4 helper cells, a lower number of hospital days, and more positive emotional responses to a general health index. It is further hypothesized that there will be interactions on these outcome measures influenced by ethnicity, age, gender, sexual orientation, education level, income level, prior health, substance abuse, and mental health history. This study will provide additional insights on specific contributions of social support patterns among different ethnic groups and on network coordination of medical services. Both are key to improve the quality of life and decrease rising health care costs for people who have HIV/AIDS. An ancillary goal is to develop a biobehavioral research training experience for undergraduate students to ensure a future cadre of researchers for communities of color.
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