Researchers and clinicians in behavioral medicine have given a great deal of attention to behavioral factors that may be associated with HIV transmission and progression. It is important that behavioral medicine expertise also be applied to assisting individuals in coping with the profound psychological demands of this disease, from the personal struggle over whether or not to be serotested to the threats and actualities of physical and mental deterioration and imminent death. Such efforts would help support the psychological well-being of infected individuals and might also have a positive impact on their physical health by maintaining social involvement, physical activity, and engagement in the health care system.
We describe a coping program that draws on two literatures: stress and coping and stress management. The literature on stress and coping helps us understand what makes events stressful for individuals and the coping processes through which the psychological demands of these events are managed. The literature on stress management helps us understand the mechanisms by which events such as serotesting, psychological factors such as hostility, and physiological factors such as autonomic reactivity can result in pathological processes that lead to adverse health outcomes. The integration of these traditions led to a program that emphasizes: (a) the appraisal process through which individuals evaluate the characteristics of potentially stressful situations; (b) emotion-focused strategies to help manage distress and regulate reactivity and problem-focused strategies to help manage the problems causing distress; and (c) knowing how to choose among coping strategies, given the characteristics of the stressful situation.
The program we present in this chapter is an example of how two approaches in behavioral medicine can be integrated to help people who are infected with HIV cope with the stresses of this disease. Ultimately, further exploration of these approaches, as well as other theoretical and clinical approaches that characterize the field of behavioral medicine, will help increase understanding and treatment of psychological stress not only for people infected with HIV but also for people who are confronted with other severe chronic illnesses.
The writing of this chapter was supported in part by grants from the National Institute of Mental Health (MH44045 and MH46805).
Antoni M. H. ( 1989, August). Psychosocial stress management and immune function among HIV-1 seropositive and seronegative gay males. Paper presented at the meting of the American Psychological Association, New Orleans.