Stress management effects on perceived stress and cervical neoplasia in low-income HIV-infected women
Stress management effects on perceived stress and cervical neoplasia in low-income HIV-infected women
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DOI：
10.1016/j.jpsychores.2008.06.002
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发表时间：
2008-10-01
影响因子：
4.7
通讯作者：
O'Sullivan, Mary Jo
中科院分区：
文献类型：
--
作者：
Antoni, Michael H.;Pereira, Deidre B.;O'Sullivan, Mary Jo
目的：感染致瘤性性传播人乳头瘤病毒（hpv）和因合并感染人类免疫缺陷病毒（HIV）而降低细胞免疫力的妇女发生宫颈肿瘤疾病的风险大大增加。这些人中的大多数是低收入的少数民族妇女。在hiv感染人群中，与HPV促进宫颈肿瘤形成相关的因素包括免疫抑制程度以及吸烟和心理压力等行为因素。本研究探讨了认知行为压力管理（CBSM）干预对HIV阳性少数民族妇女生活压力和宫颈肿瘤的影响。方法：参与者为39名近期有异常巴氏涂片史的HIV+非裔美国人、加勒比人和西班牙裔妇女。参与者在研究开始时和9个月后分别接受阴道镜检查、社会心理访谈和外周静脉血抽取，随机分配到10周CBSM组干预（n=21）或1天CBSM工作坊（n= 18）。结果：在9个月的随访中，接受10周以组为基础的CBSM干预的妇女报告说，她们感受到的生活压力减少了，宫颈瘤变的几率也显著降低。CBSM对生活压力和肿瘤的影响与研究开始时是否存在肿瘤、HPV类型、CD4+CD3+细胞计数、HIV病毒载量和药物使用无关。此外，CBSM干预对宫颈瘤变的影响在随访时残存生活压力的女性中尤为明显。结论：这些研究结果表明，压力管理可以减少感知的生活压力，并可能降低宫颈瘤变的几率与艾滋病毒和异常巴氏涂片史的妇女。虽然是初步的，但这些发现表明，压力管理作为一种预防癌症的策略在这一高危人群中是有用的。(C) 2008爱思唯尔公司版权所有。
Objective: Risk for developing cervical neoplastic disease is greatly increased in women infected with oncogenic sexually transmitted human papillomaviruses (HPVs) and who have lowered cellular immunity due to coinfection with human immunodeficiency virus (HIV) infection. The majority of these individuals are low-income minority women. Factors associated with promotion of HPV to cervical neoplasia in HIV-infected populations include degree of immunosuppression as well as behavioral factors such as tobacco smoking and psychological stress. ThiS Study examined the effects of a cognitive behavioral stress management (CBSM) intervention on life stress and cervical neoplasia in HIV+ minority women. Methods: Participants were 39 HIV+ African-American, Caribbean, and Hispanic women with a recent history of an abnormal Papanicolaou smear. Participants underwent colposcopic examination, psychosocial interview, and peripheral venous blood draw at study entry and 9 months after being randomly assigned to either a 10-week CBSM group intervention (n=21) or a 1-day CBSM workshop (n = 18). Results: Women assigned to the 10-week group-based CBSM intervention reported decreased perceived life stress and had significantly lower odds of cervical neoplasia over a 9-month follow-up. CBSM effects on life stress and neoplasia appeared independent of presence of neoplasia at Study entry, HPV type, CD4+CD3+ cell count, HIV viral load, and substance use. Furthermore, CBSM intervention effects on cervical neoplasia were especially pronounced among women with residual life stress at follow-up. Conclusion: These findings suggest that stress management decreases perceived life stress and may decrease the odds of cervical neoplasia in women with HIV and a history of abnormal Papanicolaou smears. Although preliminary, these findings suggest the utility of stress management as a cancer prevention strategy in this high-risk population. (C) 2008 Elsevier Inc. All rights reserved.