While stress is known to worsen many medical conditions such as heart disease and diabetes, recent research has also shown that stressful life events can hasten the progression to AIDS in HIV-positive patients.
A research team in the Department of Psychiatry at the University of North Carolina School of Medicine in Chapel Hill conducted a study of 82 homosexual men who were HIV-1-positive without symptoms or AIDS. These men were followed every six months for up to seven and a half years. To measure disease progression, researchers looked for a decreased CD4(+) lymphocyte count in the blood (a measure of immune functioning; a blood count of less than 200/microliter is consistent with AIDS) or one of the tumors or other conditions indicative of AIDS. The researchers also examined various health habits, the number of stressful life events, satisfaction with social support systems, and coping behaviors of the participants.
Results of this study showed that disease progression to AIDS was more rapid in the presence of severe life stressors, low levels of satisfaction with social support systems, the use of denial as a coping mechanism, and elevated cortisol levels. Other variables such as age, educational level, smoking, and risky sexual behavior were not related to faster disease progression.
This interesting study suggests that stress management strategies and efforts to improve social support systems might be useful as part of a treatment plan for HIV-positive patients. Since high levels of stress are known to negatively affect the functioning of our immune system, the observed increase in HIV disease progression in the presence of severe stressors might be expected. Chronic stress also elevates body levels of the "stress hormone" cortisol, which is also known to suppress the immune response. Elevated cortisol levels were also shown to increase progression to AIDS in this study.
These results add to the growing body of evidence supporting the critical role of the mind-body relationship in health and illness. While relaxation techniques, stress management plans, social support networks, and/or counseling alone cannot replace standard medical therapies, their value as adjuvants to standard treatments has been confirmed in patients with other conditions such as cardiovascular disease, chronic pain, and cancer.
This study on HIV disease progression was published in the August 2000
edition of the American Journal of Psychiatry. The full article can be
obtained online through the American Journal of Psychiatry Web site at http://ajp.psychiatryonline.org.
Leserman J, Pettito JM, Golden RN, Gaynes BN, Gu H, Perkins DO, Silva SG, Folds JD, and Evans DL. Impact of stressful life events, depression, social support, coping, and cortisol on progression to AIDS.
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