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Role of Depression, Stress, and Trauma in HIV Disease Progression
Abstract
Despite advances in HIV treatment, there continues to be great variability in the progression of this disease. This paper reviews the evidence that depression, stressful life events, and trauma account for some of the variation in HIV disease course. Longitudinal studies both before and after the advent of highly active antiretroviral therapies (HAART) are reviewed. To ensure a complete review, PubMed was searched for all English language articles from January 1990 to July 2007. We found substantial and consistent evidence that chronic depression, stressful events, and trauma may negatively affect HIV disease progression in terms of decreases in CD4 T lymphocytes, increases in viral load, and greater risk for clinical decline and mortality. More research is warranted to investigate biological and behavioral mediators of these psychoimmune relationships, and the types of interventions that might mitigate the negative health impact of chronic depression and trauma. Given the high rates of depression and past trauma in persons living with HIV/AIDS, it is important for healthcare providers to address these problems as part of standard HIV care.
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“The resulting consensus from this body of work is that acute life events (e.g., getting divorced or fired from a job) and chronic difficulties (e.g., ongoing marital or financial problems) increase risk for a wide variety of mental and physical health problems, including anxiety disorders, depression, autoimmune disorders, cardiovascular disease, certain cancers, and Alzheimer's disease (6–10).”
From Assessing Lifetime Stress Exposure Using the Stress and Adversity Inventory for Adults (Adult STRAIN): An Overview and Initial Validation (2018) · cites this paper as [9]
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Metadata
- Authors
- Leserman, J.
- Affiliations
- University of North Carolina at Chapel Hill (US)
- Corresponding author
- Leserman, Jane
- Venue
- Psychosomatic Medicine
- Published
- 2008-06
- Volume
- 70
- Issue
- 5
- Pages
- 539-545
- ISSN
- 0033-3174 (ISSN-L)
- OpenAlex
- W2018119542
- Cited by
- 662
- References
- 63
- Citations by year
- 2026: 6 · 2025: 9 · 2024: 22 · 2023: 18 · 2022: 35 · 2021: 37 · 2020: 35 · 2019: 45 · 2018: 43 · 2017: 86 · 2016: 47 · 2015: 35 · 2014: 38 · 2013: 44 · 2012: 50
- FWCI
- 4.28
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Psychosomatic Medicine (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Center for Complementary and Integrative Health (R01AT002035)
- 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
- HIV disease progression, depression, stress, trauma, life events, CD4 count, viral load, clinical deterioration, mortality, psychoneuroimmunology, highly active antiretroviral therapy, psychosocial interventions
- MeSH terms
- Depressive Disorder, Health Services Needs and Demand, Humans, Life Change Events, Longitudinal Studies, Patient Care Team, Patient Compliance, Psychoneuroimmunology, Risk Factors, Stress, Psychological, HIV Infections, Comorbidity, Disease Progression, CD4 Lymphocyte Count, Viral Load, Antiretroviral Therapy, Highly Active
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