title: Reductions in herpes simplex virus type 2 antibody titers after cognitive behavioral stress management and relationships with neuroendocrine function, relaxation skills, and social support in HIV-positive men.
abstract: OBJECTIVE
  Coinfection with herpes simplex virus type 2 (HSV-2) is common in individuals infected with human immunodeficiency virus (HIV) and may have health implications. This study examined the effect of a 10-week cognitive behavioral stress management (CBSM) intervention on immunoglobulin G (IgG) antibody titers to HSV-2 in a group of mildly symptomatic HIV-infected gay men and the degree to which these effects were mediated by psychosocial and endocrine changes during the 10-week period.
  
  
  METHODS
  Sixty-two HIV+ gay men were randomly assigned to either a 10-week CBSM intervention (N = 41) or a wait-list control condition (N = 21). Anxious mood, social support, cortisol/dehydroepiandrosterone sulfate (DHEA-S) ratio levels, and HSV-2 IgG antibody titers were assessed at baseline and after the 10-week period. CBSM participants also recorded their stress levels before and after at-home relaxation practice.
  
  
  RESULTS
  HSV-2 IgG titers were significantly reduced in the CBSM participants but remained unchanged in the control group after the 10-week intervention period. Increases in one type of social support, perceived receipt of guidance, during the 10 weeks was associated with and partially mediated the effect of the intervention on HSV-2 IgG. Similarly, decreases in cortisol/DHEA-S ratio levels were associated with decreases in HSV-2 IgG, and lower mean stress levels achieved after home relaxation practice were associated with greater decreases in HSV-2 IgG among CBSM participants.
  
  
  CONCLUSIONS
  These findings suggest that behavioral and psychosocial changes occurring during CBSM interventions, including relaxation, enhanced social support, and adrenal hormone reductions, may help to explain the effects of this form of stress management on immune indices such as HSV-2 antibody titers.
authors.affiliation: Department of Psychology, University of Miami, FL, USA.
authors.forename: S
authors.initials: S
authors.lastname: Cruess
authors.forename: M
authors.initials: M
authors.lastname: Antoni
authors.forename: D
authors.initials: D
authors.lastname: Cruess
authors.forename: M A
authors.initials: MA
authors.lastname: Fletcher
authors.forename: G
authors.initials: G
authors.lastname: Ironson
authors.forename: M
authors.initials: M
authors.lastname: Kumar
authors.forename: S
authors.initials: S
authors.lastname: Lutgendorf
authors.forename: A
authors.initials: A
authors.lastname: Hayes
authors.forename: N
authors.initials: N
authors.lastname: Klimas
authors.forename: N
authors.initials: N
authors.lastname: Schneiderman
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000914:Antibodies, Viral / Q000097:blood*; D001727:Bisexuality / Q000523:psychology; D015928:Cognitive Behavioral Therapy; D019314:Dehydroepiandrosterone Sulfate / Q000097:blood*; D006679:HIV Seropositivity / Q000276:immunology / Q000523:psychology*; D006558:Herpes Genitalis / Q000276:immunology / Q000523:psychology*; D018258:Herpesvirus 2, Human / Q000276:immunology*; D018451:Homosexuality, Male / Q000523:psychology; D006801:Humans; D006854:Hydrocortisone / Q000097:blood*; D008297:Male; D008875:Middle Aged; D012064:Relaxation Therapy; D012944:Social Support; D013315:Stress, Psychological / Q000150:complications
chemical_list: D000914:Antibodies, Viral; D019314:Dehydroepiandrosterone Sulfate; D006854:Hydrocortisone