Cited by 204HIV/AIDS Research and InterventionsHIV Research and TreatmentStress Responses and Cortisol

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Stress management interventions for HIV+ adults: A meta-analysis of randomized controlled trials, 1989 to 2006.

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Scott-Sheldon, Lori A. J., Kalichman, Seth C., Carey, Michael P., Fielder, Robyn L.·2008·Health Psychology

DOI 10.1037/0278-6133.27.2.129PMC PMC2409585

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Abstract

OBJECTIVE: Numerous studies document that stress accelerates disease processes in a variety of diseases including HIV. As a result, investigators have developed and evaluated interventions to reduce stress as a means to improve health among persons living with HIV. Therefore, the current meta-analysis examines the impact of stress-management interventions at improving psychological, immunological, hormonal, and other behavioral health outcomes among HIV+ adults. DESIGN: This meta-analytic review integrated the results of 35 randomized controlled trials examining the efficacy of 46 separate stress management interventions for HIV+ adults (N=3,077). MAIN OUTCOME MEASURES: Effect sizes were calculated for stress processes (coping and social support), psychological/psychosocial (anxiety, depression, distress, and quality of life), immunological (CD4+ counts and viral load), hormonal (cortisol, dehydroepiandrosterone sulfate [DHEA-S], cortisol/DHEA-S ratio, and testosterone) and other behavioral health outcomes (fatigue). RESULTS: Compared to controls, stress-management interventions reduce anxiety, depression, distress, and fatigue and improve quality of life (d+s=0.16 to 0.38). Stress-management interventions do not appear to improve CD4+ counts, viral load, or hormonal outcomes compared with controls. CONCLUSION: Overall, stress-management interventions for HIV+ adults significantly improve mental health and quality of life but do not alter immunological or hormonal processes. The absence of immunological or hormonal benefits may reflect the studies' limited assessment period (measured typically within 1-week postintervention), participants' advanced stage of HIV (HIV+ status known for an average of 5 years), and/or sample characteristics (predominately male and White participants). Future research might test these hypotheses and refine our understanding of stress processes and their amelioration.

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Authors: Scott-Sheldon, L. A. J., Kalichman, S. C., Carey, M. P., & Fielder, R. L.
Affiliations: University of Connecticut (US)
Syracuse University (US)
ORCID: Kalichman, Seth C.
Carey, Michael P.
Venue: Health Psychology
Publisher: American Psychological Association (APA)
Published: 2008
Volume: 27
Issue: 2
Pages: 129-139
ISSN: 0278-6133 (ISSN-L)
1930-7810
DOI: 10.1037/0278-6133.27.2.129
PMC: PMC2409585
OpenAlex: W2024424432
Cited by: 204
References: 80
Citations by year: 2025: 1 · 2024: 2 · 2023: 2 · 2022: 3 · 2021: 1 · 2020: 9 · 2019: 9 · 2018: 9 · 2017: 45 · 2016: 9 · 2015: 5 · 2014: 6 · 2013: 14 · 2012: 26
FWCI: 2.44
Type: journal article
Language: en
Open access: green
www.ncbi.nlm.nih.gov
Locations: Health Psychology (publishedVersion)
PubMed (publishedVersion)
PubMed Central (acceptedVersion)
Funders: National Institutes of Health (R01-MH71164, R01-MH068171)
Topics: Health Sciences › Medicine › Infectious Diseases › HIV/AIDS Research and Interventions
Life Sciences › Immunology and Microbiology › Virology › HIV Research and Treatment
Life Sciences › Neuroscience › Behavioral Neuroscience › Stress Responses and Cortisol
Keywords: stress management interventions, HIV, people living with HIV, coping, social support, anxiety, depression, psychological distress, quality of life, fatigue, CD4 count, viral load, cortisol, dehydroepiandrosterone sulfate, testosterone, immunological outcomes
MeSH terms: Adaptation, Psychological, Arousal, Behavior Therapy, HIV Seropositivity, Hydrocortisone, Pyridines, Stress, Psychological, Testosterone, Randomized Controlled Trials as Topic, CD4 Lymphocyte Count, Dehydroepiandrosterone Sulfate, Viral Load

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Stress management interventions for HIV+ adults: A meta-analysis of randomized controlled trials, 1989 to 2006.

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