The Role of Positive Affect in Adjustment to HIV

描述(由申请人提供)：越来越多的文献表明，积极的情绪在适应慢性压力的过程中可能具有独特的适应作用，独立于抑郁等负面情绪的影响。这项研究的总体目标是为艾滋病毒携带者制定干预措施提供证据和方向，其中包括关注积极影响。为此，这项研究将记录在HIV+血清状态通知后18个月期间积极情绪的发生、预测因素和后果。这是一项纵向队列研究，从旧金山湾区4个地点招募的250名参与者将在接到HIV+血清状态通知后的18个月内接受7次访谈。数据将包括定量问卷、定性访谈(录音)以及CD4和病毒载量测量。这项研究的具体目的是：1)记录250名男性和女性在18个月的过程中，在接到HIV+血清状态通知(以及相关应激源的级联)时，积极和消极情绪共同出现的情况；2)通过考察积极情绪与依从性、HIV危险行为、医疗保健利用、健康行为、角色功能、生活质量和临床抑郁症状的独特同步和前瞻性关联，来探索积极情绪的潜在适应意义；以及3)确定应对过程(例如，以问题为中心的应对、积极的重新评价、有意义的事件)和应对资源(例如，社会支持、自尊、乐观)，这些都与随着时间的推移积极情绪的增加独一无二地相关。此外，我们还有两个次要目标：1)探索积极情感与HIV进展的关系，如CD4、病毒载量和症状；2)基于医疗保健利用率和药物成本，探索积极情感与HIV治疗成本的关系。

DESCRIPTION (provided by applicant): A growing body of literature indicates that positive affect may have a unique adaptive role in the process of adjustment to chronic stress, independent of the effects of negative affects like depression. The overarching goal of this research is to provide evidence and direction for the development of interventions for people with HIV that include a focus on positive affect. To this end, this study will document the occurrence, predictors, and consequences of positive affect during the 18 months post-notification of HIV+ serostatus. This is a longitudinal cohort study in which 250 participants recruited from 4 San Francisco Bay area sites will be interviewed 7 times over the course of 18 months after notification of HIV+ serostatus. Data will consist of quantitative questionnaires, qualitative interviews (audio taped), and CD4 and viral load measures. The specific aims of the study are to: 1) Document the co-occurrence of positive and negative affect in response to notification of HIV+ serostatus (and the cascade of associated stressors) over the course of 18 months in a sample of 250 men and women; 2) Explore the potential adaptational significance of positive affect by examining its unique concurrent and prospective associations with adherence, HIV risk behaviors, healthcare utilization, health behaviors, role functioning, quality of life, and symptoms of clinical depression; and 3) Identify coping processes (e.g., problem focused coping, positive reappraisal, meaningful events) and coping resources (e.g., social support, self esteem, optimism) that are uniquely associated with increases in positive affect over time. In addition, we have two secondary aims: 1) To explore the association of positive affect with progression of HIV as evidenced by CD4, viral load, and symptoms; and 2) To explore the association of positive affect with cost of HIV treatment based on healthcare utilization and medication costs.