Spiritual Transformation, Psychological Well-Being, Health, and Survival in People with HIV

Ironson, Gail; Kremer, Heidemarie

doi:10.2190/pm.39.3.d

Cited by 110Religion, Spirituality, and PsychologyWorkplace Spirituality and LeadershipHIV/AIDS Research and Interventions

Spiritual Transformation, Psychological Well-Being, Health, and Survival in People with HIV

Ironson, Gail, Kremer, Heidemarie·2009·The International Journal of Psychiatry in Medicine

DOI 10.2190/pm.39.3.d

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Abstract

Objectives: Although Spiritual Transformation (ST) occurs in a sizable proportion of people with HIV (about 39%), there is little research on the potential benefits of ST with respect to psychological well-being, health, and survival in this population. Our study attempts to fill this gap. Method: Using a mixed method approach, we related interviews of 147 people with HIV (identifying the presence/absence of ST) to questionnaires measuring demographics, medical history, treatment adherence, physical symptoms, and psychological well-being (i.e., stress, coping, life attitude, and spirituality), and assessments of CD4-counts and viral load and survival 3 to 5 years later. Results: At comparable times since HIV-diagnosis and antiretroviral medications prescribed, the presence of ST was significantly associated with better treatment success (undetectable viral loads, higher CD4 counts), better medication adherence, fewer symptoms, less distress, more positive coping, different life attitudes (i.e., existential transcendence, meaning/purpose in life, optimism, death acceptance), more spiritual practices, and increased spirituality. ST was also associated with substance-use recovery and with being African American. Survival up to 5 years was 5.35 times more likely among participants with ST ( p f = .044). According to a Cox-regression adjusted for baseline CD4-counts, age, race-ethnicity, gender, education, years since HIV-diagnosis, and a history of substance-use problems, ST still reduced the risk of death (HR = 0.07, 95% CI = 0.01–0.53, p = .010). Conclusions: ST has associated benefits for psychological well-being, health, and survival.

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Considering the 63 methodologically most rigorous studies (quality ratings of 8 or higher), 47 (75%) found R/S predicting greater longevity (two at trend level).
“Considering the 63 methodologically most rigorous studies (quality ratings of 8 or higher), 47 (75%) found R/S predicting greater longevity (two at trend level) [548–566], whereas three (5%) reported shorter longevity [567–569].”
From Religion, Spirituality, and Health: The Research and Clinical Implications (2012) · cites this paper as [554]

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Spiritual and religious aspects influence mental health and viral load: A quantitative study among young people living with HIV in ZimbabwePreprint
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Summary and Conclusions
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Preface
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Health Policy Implications
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Introduction
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Diet and Weight
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Dedication
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Personality Traits and Disorders
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Schizophrenia and Other Psychoses
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Everything Changed: Spiritual Transformation in People with HIV
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Authors: Ironson, G., & Kremer, H.
Affiliations: University of Miami (US)
Corresponding author: Ironson, Gail
ORCID: Ironson, Gail
Kremer, Heidemarie
Venue: The International Journal of Psychiatry in Medicine
Publisher: SAGE Publications
Published: 2009-09
Volume: 39
Issue: 3
Pages: 263-281
ISSN: 0033-278X (ISSN-L)
0091-2174
1541-3527
DOI: 10.2190/pm.39.3.d
OpenAlex: W1969531962
Cited by: 110
References: 56
Citations by year: 2026: 1 · 2025: 2 · 2023: 44 · 2022: 3 · 2021: 4 · 2020: 2 · 2019: 3 · 2018: 4 · 2017: 6 · 2016: 5 · 2015: 5 · 2014: 6 · 2013: 4 · 2012: 4
FWCI: 6.91
Type: journal article
Language: en
Open access: closed
Licence: journals.sagepub.com/page/policies/text-and-data-mining-license (tdm)
Locations: The International Journal of Psychiatry in Medicine (publishedVersion)
PubMed (publishedVersion)
Funders: National Institute of Mental Health (R01MH066697, R01 MH53791, R01MH053791)
Topics: Social Sciences › Health › Religion, Spirituality, and Psychology
Social Sciences › Demography › Workplace Spirituality and Leadership
Health Sciences › Medicine › Infectious Diseases › HIV/AIDS Research and Interventions
Keywords: spiritual transformation, HIV, psychological well-being, survival, spirituality, coping, meaning in life, substance use disorder recovery, medication adherence, CD4 count, viral load, African Americans
MeSH terms: Adaptation, Psychological, Adult, Depression, Female, Health Status, Humans, Life Change Events, Longitudinal Studies, Male, Stress, Psychological, United States, HIV Infections, Survival Rate, Proportional Hazards Models, Case-Control Studies, CD4 Lymphocyte Count, Viral Load, Spirituality

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Spiritual Transformation, Psychological Well-Being, Health, and Survival in People with HIV

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