Reports From the Field

Stress speeds AIDS progression

A recent study suggests that stress, poor coping mechanisms, low levels of social support, and depression may speed progression to AIDS in HIV-infected individuals.

Researchers studied 82 homosexual men with HIV type-I infection every six months for 7.5 years. Men were recruited from rural and urban areas in North Carolina, and none was using antiretroviral medication at entry. Disease progression was defined as CD4 count < 200/µl or the presence of an AIDS indicator condition.

Researchers found that faster progression to AIDS was associated with higher cumulative average stressful life events, coping by means of denial, lower cumulative average satisfaction with social support, and higher serum cortisol levels. Other variables, including tobacco use, age, education, and risky sexual behavior, did not significantly predict disease progression. Researchers found that the risk of AIDS roughly doubled for each of the following:

  • every 1.5-unit decrease in cumulative average support satisfaction;
  • every cumulative average increase in severe life stressors;
  • every unit of denial;
  • every 5 mg/dL of cortisol.

[See: Leserman J, Petitto JM, Golden RN, et al. Impact of stressful life events, depression, social support, coping, and cortisol on progression to AIDS. Am J Psychiatry 2000; 157:1,221-1,228.]