Distress, denial, and low adherence to behavioral interventions predict faster disease progression in gay men infected with human immunodeficiency virus.
Distress, denial, and low adherence to behavioral interventions predict faster disease progression in gay men infected with human immunodeficiency virus.
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DOI：
10.1207/s15327558ijbm0101_6
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发表时间：
1994-01-01
影响因子：
2.7
通讯作者：
Schneiderman, N
中科院分区：
文献类型：
--
作者：
Ironson, G;Friedman, A;Schneiderman, N
这项研究检查了男同性恋者在发现他们的人类免疫缺陷病毒（HIV）血清状态后2年疾病进展的心理预测。监测无症状男同性恋者的心理和免疫状况，这些男同性恋者不知道自己的HIV血清状态。这些人被随机分配到一项运动中。认知行为压力管理干预，或控制组。对23名血清检测呈阳性的男性进行了2年的随访。9人出现症状，其中5人患有获得性免疫缺陷综合征，其中4人死亡。诊断时的痛苦，否认（诊断后5周减去诊断前）。干预期间的低依从性是2年疾病进展的重要预测因素。拒绝和坚持治疗仍然是疾病进展的重要预测因素，即使在控制了入院时的CD4数量后也是如此。此外。拒绝改变与1年后免疫状态显著相关；l年免疫状态与2年疾病进展显著相关。因此，本研究一方面证明了心理变量与免疫措施和HIV-1疾病进展之间的显著关系。我们的结论是，苦恼、拒绝和低方案依从性预测了随后的疾病进展。
This study examined psychological prediction of 2-year disease progression in gay men after finding out their human immunodeficiency virus (HIV) serostatus. Psychological and immune status of asymptomatic gay men who did not know their HIV serostatus was monitored during the 5 weeks before and after serostatus notification. The men were randomly assigned to an exercise. cognitive-behavioral stress-management intervention, or control group. At 2-year follow-up for the 23 men who turned out to be seropositive. 9 had developed symptoms, including 5 with acquired immune deficiency syndrome--4 of whom died. Distress at diagnosis, denial (5 weeks post-diagnosis minus pre-diagnosis). and low adherence during interventions were significant predictors of 2-year disease progression. Denial and adherence remained significant predictors of disease progression even after controlling for CD4 number at entry. Furthermore. change in denial was significantly correlated with immune status 1 year later; l-year immune status was significantly correlated with 2-year disease progression. The present study therefore demonstrates significant relations between psychological variables on the one hand and both immune measures and HIV-1 disease progression on the other. We conclude that distress, denial, and low protocol compliance predict subsequent disease progression.