title: Effects of AIDS-related bereavement on HIV progression among New York City gay men.
abstract: This study investigates the relationship between early AIDS-related bereavement and subsequent changes in CD4 T-cell levels and health over a three- to four-year follow-up period in 85 HIV positive gay men. In addition, two psychological responses to loss, grief, and depression were distinguished and used as predictors of changes in health following loss. Interview data collected each year was used to assess psychological, behavioral and health factors. Blood samples drawn yearly were used to assess CD4 T-cell levels. Results indicate that those who had experienced an AIDS-related bereavement event prior to entry into the study showed a more rapid loss of CD4 T-cells over time, controlling for age, initial health status, use of antiretrovirals, sedatives, recreational drugs, cigarettes, and alcohol as well as other potential confounding factors. CD4 loss-rate differences were observable by two years post-bereavement. In addition, grief reactions were distinguishable from depressive reactions. Grief reactions were unrelated to CD4 decline and symptom onset while aspects of depression, specifically self-reproach, were predictive of CD4 loss. These data suggest that bereavement may impact biological systems relevant to HIV progression and that distinguishing specific responses to loss may improve our understanding of these relationships.
authors.affiliation: Department of Psychiatry & Biobehavioral Sciences, University of California, Los Angeles 90024, USA.
authors.forename: M E
authors.initials: ME
authors.lastname: Kemeny
authors.forename: L
authors.initials: L
authors.lastname: Dean
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000401:mortality*; D000293:Adolescent; D000328:Adult; D000368:Aged; D001601:Bereavement; D018791:CD4 Lymphocyte Count; D003863:Depression / Q000150:complications; D018450:Disease Progression; D015658:HIV Infections / Q000523:psychology*; D006304:Health Status; D018451:Homosexuality, Male; D006801:Humans; D008297:Male; D008875:Middle Aged; D009519:New York City / Q000453:epidemiology