An increase in religiousness/spirituality occurs after HIV diagnosis and predicts slower disease progression over 4 years in people with HIV.
BACKGROUND
Most studies on religion/spirituality predicting health outcomes have been limited to church attendance as a predictor and have focused on healthy people. However, confronting a major medical crisis may be a time when people turn to the sacred.


OBJECTIVE
The purpose of this study was to determine the extent to which changes in spirituality/religiousness occur after HIV diagnosis and whether changes predict disease progression.


METHODS
This longitudinal study examined the relationship between changes in spirituality/religiousness from before with after the diagnosis of HIV, and disease progression (CD4 and viral load [VL] every 6 months) over 4 years in 100 people with HIV. Measures included change in religiousness/spirituality after diagnosis of HIV, religiousness/spirituality at various times in one's life, church attendance, depression, hopelessness, optimism, coping (avoidant, proactive), social support, CD4/VL, and health behaviors.


RESULTS
Forty-five percent of the sample showed an increase in religiousness/spirituality after the diagnosis of HIV, 42% remained the same, and 13% decreased. People reporting an increase in spirituality/religiousness after the diagnosis had significantly greater preservation of CD4 cells over the 4-year period, as well as significantly better control of VL. Results were independent of (i.e., held even after controlling for) church attendance and initial disease status (CD4/VL), medication at every time point, age, gender, race, education, health behaviors (adherence, risky sex, alcohol, cocaine), depression, hopelessness, optimism, coping (avoidant, proactive), and social support.


CONCLUSIONS
There is an increase in spirituality/religiousness after HIV diagnosis, and this increase predicts slower disease progression; medical personnel should be aware of its potential importance.
Ironson
Gail
G
Department of Psychology, University of Miami, Miami, FL, USA. gironson@aol.com
Stuetzle
Rick
R
Fletcher
Mary Ann
MA
D000223:Adaptation, Psychological; D015984:Causality; D018450:Disease Progression; D005431:Florida / Q000453:epidemiology; D015658:HIV Infections / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology*; D006801:Humans; D008016:Life Change Events; D008137:Longitudinal Studies; D012069:Religion and Psychology; D012309:Risk-Taking; D012944:Social Support