A longitudinal study of the neuropsychiatric consequences of HIV-1 infection in gay men. II Psychological and health status at baseline and at 12-month follow-up

Abstract

SynopsisThe aim of this study was to determine whether HIV infection is associated with increased psychosocial distress in the asymptomatic and early symptomatic stages of disease and to determine the factors associated with reporting health symptoms. Subjects included 61 gay men (41 HIV −, 20 HIV +) who were assessed at the time of requesting their first HIV test and again 12 months later. Measures included a detailed standardized psychiatric interview (Present State Examination, PSE), a range of psychosocial self-report measures and a physical symptom checklist. There were no differences between the HIV + and HIV − groups in terms of self-reported symptoms. Multiple regression analysis showed that the symptom reporting was not associated with clinical or immunological markers of disease progression but was associated with measures of psychosocial distress. Although both groups showed elevated levels of psychosocial distress at the time of HIV testing, there were no differences between serostatus groups at follow-up. Multiple regression analysis indicated that the best predictors of PSE scores at follow-up were baseline PSE score and a history of psychiatric illness. Early HIV disease is not associated with increased psychosocial distress and symptom reporting is more closely related to psychological measures than to clinical or immunological markers of disease.

Patterns of responses on health-related quality of life questionnaires among patients with HIV/AIDS

“…Of the clinical measures, only CD4 count was significantly associated with class membership, for Classes 4 and 6 in relation to Class 1. Previous research indicates that clinical measures are not usually related to HRQoL, 36,37 but our study indicates that they may be in some circumstances. Nevertheless, clinical measures were not consistently associated with function, which raises the question of what HRQoL measures in this population are tapping.…”

Multiple Dimensions of HIV Stigma and Psychological Distress Among Asians and Pacific Islanders Living With HIV Illness

“…Findings from this study, which represent the first research effort that we are aware of to examine the psychological sequelae of illness stigma among HIV-seropositive APIs in the US, clearly suggest that HIV stigma is a multidimensional construct that affects psychological distress. Social Rejection, Negative Self-Worth, and Perceived Interpersonal Insecurity were associated with heightened level of distress, after control for country of origin and self-reported physical symptoms, a well-documented predictor of psychological distress (Griffin and Rabkin, 2000;Pugh et al, 1994). Numerous studies of persons living with HIV/AIDS have supported the associations between psychological distress and perceived social support (Hudson et al, 2001;Fleishman et al, 2000), HIV illness progression (Golub et al, 2003), physical functioning (Vogl et al, 1999) and spirituality (Tuck et al, 2001;Ironson et al, 2002).…”

Mood disorders in HIV infection

“…Additionally, worsening of fatigue and insomnia at 6 month follow up was highly correlated with worsening depression but not CD4 count, change in CD4 count, or disease progression by CDC category. Others have also found that these symptoms are more closely associated with depression than with HIV disease progression [23]. While viral load may provide a more sensitive indicator of HIV burden, the issue of discrimination of major depression from HIV related symptoms will involve clinical experience and judgment until a laboratory marker of major depression is found.…”