Stress management effects on perceived stress and cervical neoplasia in low-income HIV-infected women

Abstract

Objective Cervical intraepithelial neoplasia (CIN) is greatly increased in women infected with sexually transmitted Human Papillomaviruses (HPVs) and who are co-infected with Human Immunodeficiency Virus (HIV) infection. Factors associated with promotion of HPV to CIN in these women include degree of immunosuppression and preventable behavioral factors such as tobacco smoking and psychological stress. Interventions such as cognitive behavioral stress management (CBSM) decrease stress and modulate disease activity in HIV-infected men though effects have not been established in HIV-infected women. This study examined the effects of CBSM on life stress and CIN 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 one-day CBSM workshop (n = 18). Results Women assigned to the 10-week CBSM intervention reported decreased perceived life stress and had significantly lower odds of CIN over a 9-month follow-up, independent of CIN at study entry, HPV type, CD4+CD3+ cell count, HIV viral load, and tobacco smoking. Women free of CIN at follow-up reported decreases in perceived stress over time while those with CIN reported increases in perceived stress over the same period. Conclusion Although preliminary these findings suggest that stress management decreases perceived life stress and may decrease the odds of CIN in women with HIV and HPV.

Stress management interventions for HIV-infected individuals: review of recent intervention approaches and directions for future research

“…108 Women in the intervention condition endorsed decreased perceived life stress and had lower odds of cervical intraepithelial neoplasia over 9 months relative to the one psychoeducational control session. 108 Weiss and colleagues 109 summarized the findings from two linked intervention trials of a CBSM intervention for HIV-infected women. The first trial compared a 10-week intervention to an individual psychoeducational condition.…”

“…In addition to the computer-delivered intervention developed by Brown and colleagues for HIV-infected women, 100,101 two intervention trials evaluated the efficacy of a CBSM intervention tailored to the unique psychosocial stressors faced by HIV-infected women. 108,109 The first study examined the impact of a 10-week CBSM intervention on cervical intraepithelial neoplasia, the neoplastic changes that occur following sexual transmission of human papillomaviruses and are precursors to cervical cancer. 108 Women in the intervention condition endorsed decreased perceived life stress and had lower odds of cervical intraepithelial neoplasia over 9 months relative to the one psychoeducational control session.…”

“…108,109 The first study examined the impact of a 10-week CBSM intervention on cervical intraepithelial neoplasia, the neoplastic changes that occur following sexual transmission of human papillomaviruses and are precursors to cervical cancer. 108 Women in the intervention condition endorsed decreased perceived life stress and had lower odds of cervical intraepithelial neoplasia over 9 months relative to the one psychoeducational control session. 108 Weiss and colleagues 109 summarized the findings from two linked intervention trials of a CBSM intervention for HIV-infected women.…”

167: Event-Related Distress in Kidney Disease Patients

“…disease-related outcomes, mood and functioning [27][28][29][30][31][32][33]. Pending evidence from similar trials with CKD and CKD5 patients, renal practitioners seeking to provide optimal care may want to consider the impact of stressful life events on patients, whether or not these events are related to kidney disease.…”

Avaliação de Treino de Controle do Stress para Mães de Crianças com Transtornos do Espectro Autista

“…De acordo com Lipp e Malagris (2011) a abordagem psicoterapêutica cognitivo-comportamental para o controle do stress possibilita não só a reestruturação cognitiva, ou seja, uma forma mais realista e adaptativa de entender as situações vivenciadas, como também ampliação do repertório comportamental e emocional para o manejo funcional dos estressores. Em concordância à proposição das autoras, o manejo psicológico do stress excessivo tem sido testado, em diversas populações clínicas e não clínicas, há décadas, em pesquisas internacionais (Antoni et al, 2009;Bougea, Darviri, & Alexopoulos, 2011;Keypour, Arman, & Maracy, 2011;Lutgendorf et al, 1998;Steinmetz, Kaplan, & Miller, 1982). No Brasil, diferentes intervenções com populações diversas de variadas faixas etárias vêm sendo conduzidas por vários autores que obtêm êxito utilizando o Treino de Controle do Stress (TCS) de Lipp (1984;Lipp & Malagris, 2011).…”