The purpose of the training program is to provide systematic predoctoral and postdoctoral research training into the psychosocial and biobehavioral factors in the management of HIV/AIDS. Training is coordinated with multiple NIH NIMH R01 grants as well as HIV/AIDS and behavior related grants from other NIH institutes (NCI, NIDA, NHLBI). Much of the research examines the effects of stressors and/or stress management interventions on adjustment to HIV and how these processes relate to clinical, immunologic, and Virologic indicators of disease progression. Thus, in one project we are testing the effects of a Cognitive Behavioral Stress Management (CBSM) intervention on distress, adherence to highly active antiretroviral therapy, CD4 cells and HIV viral load in gay and bisexual HIV-infected men. In another project we are testing a similar intervention's effects on these outcome variables in HIV-infected women. Still another study is examining biological mediators (cortisol, NK cells, cytotoxic T lymphocytes) between psychological factors and disease progression in women and men with HIV. In various projects subjects are assessed for autonomic (cardiac contractility, respiratory sinus arrhythmia), neuroendocrine (salivary cortisol, plasma catecholamines, urinary hormonal measures), and immuno-cellular (lymphocyte phenotypes, lymphocyte activation and adhesion markers, NK number and cytotoxicity), responses to acute psychosocial challenges (evaluative speech stressor) and physical exercise pre- and post-CBSM treatment. Much of our research focuses upon Black and Hispanic men and women so that training in cultural sensitivity is imperative, and this is made explicit in the training environment as well as through courses on topics such as Ethics, Ethnicity, and Gender. Although emphasis at both the pre and postdoctoral level is upon research, available didactic training includes multiple courses in advanced statistics as well as courses in psychoneuroimmunology, psychophysiology, behavioral medicine, and psychological assessment and biobehavioral interventions in physical disorders. Coursework is also available in immunology, physiology, epidemiology, mechanisms of disease, neurobiology, nutrition, pharmacology, etc. Both pre- and postdoctoral trainees undergo rotations through immunology, endocrinology, psychiatric and psychosocial assessment, health, statistics, and psychophysiologic instrumentation core laboratories. ? ? ? ?
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