Mind Over Matter

The way HIVers deal with stress can affect how rapidly the virus can cause disease progression, according to researchers. In a study of 174 men and women, patients who handled stress in emotionally healthy ways did better at fending off HIV, according to Harvard University Medical School psychologist Conall O'Cleirigh, who coauthored the study report with Gail Ironson of Florida's University of Miami. O'Cleirigh presented the report at the American Psychosomatic Society meeting, held in Budapest in March. At their first lab measurements, participants were asked to write an essay describing their emotional responses to a traumatic life event'most of these involved HIV. Every six months for four years the researchers measured participants' CD4 count and viral load. Without knowing patients' lab results, the researchers analyzed the essays based on four elements: ' Realism: Patients neither minimized nor exaggerated health threats. ' Healthy self-esteem: Patients were aware of their positive qualities. ' Tackling problems head on: Patients did not ignore HIV-related troubles or seek escape through drugs or alcohol. ' Emotional venting: Patients did not bottle up emotions. When patients' disease stage, medications, education, and other factors that might affect HIV progression were taken into account., those who showed better coping methods at the start had a slower decline of virus-fighting cells and less HIV in their blood. O'Cleirigh suggests that patients who are not avoiding their problems and are not paralyzed by stress might be more likely to find a good doctor and take their medicines, thus improving their prognosis. They 'also may reap benefits to their immune system because they're coping well with stress,' he adds. Doctors should examine their HIV patients' skills at handling stress, according to O'Cleirigh, and refer distressed patients to counseling that teaches better coping methods.