Stress Management, Depression and Immune Status in Lower Income Racial/Ethnic Minority Women Co-infected with HIV and HPV.

The stress of co-infection with HIV and Human Papillomavirus (HPV), in race/ethnic minority women, may increase depression and immune decrements. Compromised immunity in HIV+ HPV+ women may increase the odds of cervical dysplasia. Thus we tested the efficacy of a 10-wk cognitive behavioral stress management (CBSM) group intervention and hypothesized that CBSM would decrease depression and improve immune status (CD4+ T-cells, natural killer [NK] cells). HIV+HPV+ women (n=71) completed the Beck Depression Inventory (BDI) and provided blood samples, were randomized to CBSM or a control condition, and were re-assessed post-intervention. Women in CBSM revealed less depression, greater NK cells, and marginally greater CD4+ T-cells post-intervention vs. controls. Stress management may improve mood and immunity in HIV+HPV+ lower income minority women.

Ethnic identity and perceived stress in HIV+ minority women: the role of coping self-efficacy and social support.

BACKGROUND: Ethnic minority women living with HIV (WLWH) face multiple stigmas that can contribute to overwhelming levels of stress, which could hamper their ability to manage their chronic disease. Little is known about whether having a greater sense of ethnic identity might insulate WLWH from stress. It is also possible that certain cognitive and interpersonal factors (i.e., coping self-efficacy and perceived social support) may act as mediators of this relationship. We hypothesized that WLWH with a greater sense of ethnic identity would report less stress because they access these cognitive and interpersonal resources to better manage stressors. PURPOSE: The present study (1) related ethnic identity to perceived stress and (2) examined coping self-efficacy and social support as co-mediators of this relationship in a sample of low-income minority WLWH. METHOD: Ninety-two minority women (89% African American) completed self-report psychosocial measures including the Multigroup Ethnic Identity Measure (MEIM), Perceived Stress Scale (PSS), Cognitive Coping Self-efficacy Scale (CCSE), and Social Provision Scale (SPS). RESULTS: Greater ethnic identity was associated with less perceived stress, and this relationship was mediated by greater levels of both coping self-efficacy and social support. CONCLUSIONS: WLWH who identify more with their ethnic group may experience less stress via their access to more cognitive and interpersonal resources.

Men's serostatus disclosure to parents: associations among social support, ethnicity, and disease status in men living with HIV.

BACKGROUND: Directly disclosing a positive HIV serostatus to family members can affect psychological and disease status. Perceptions that one is in a supportive family environment may moderate these effects; however, ethnic differences may exist in the support processes of families coping with HIV. METHODS: We examined the role of serostatus disclosure to parents, HIV-specific family support, and ethnicity (Latino versus non-Hispanic White) in explaining disease status (HIV Viral Load, CD4+ cell count) in a sample of men living with HIV (MLWH). Men (n=120) reported whether they had disclosed their serostatus to their mothers and fathers, rated their perceptions of HIV-specific social support received from family members, and provided morning peripheral venous blood samples to assess immune function. We also collected psychosocial and urinary neuroendocrine indicators of stress/distress as possible mediator variables. RESULTS: A three-way interaction emerged between serostatus disclosure to mothers, HIV-specific family support, and ethnicity in explaining both viral load and CD4+ cell count. Non-Hispanic White men who had disclosed to mothers and were receiving high family support had a lower viral load and higher CD4+ cell count, but Latino men who had disclosed to mothers and were receiving low family support had a higher viral load. These associations were not accounted for by men's medication adherence, psychological distress, or neuroendocrine hormones. Disclosure to fathers was not related to disease status. CONCLUSIONS: The effects of serostatus disclosure on disease status may depend, in part, on ethnic differences in the interpersonal processes of men's close family relationships.