The impact of denial on health-related quality of life in patients with HIV.
OBJECTIVE
The purpose of this study was to examine the influence of denial coping on quality of life (QOL) over time among individuals living with HIV, as denial has been understudied as a coping strategy within the literature on HIV/AIDS.


METHODS
In a sample of 65 adult men and women, we used multilevel linear modeling to test trajectories of change in physical and mental health-related QOL across baseline, 3, 6, and 12 months, including denial as a predictor and gender as a moderator.


RESULTS
The use of denial coping was associated with lower physical and mental health-related QOL at baseline. Denial coping predicted an increase in QOL over time, though QOL remained low in those who practiced denial coping. Men's baseline mental health-related QOL was more negatively affected by denial coping than women's. Women tended to increase in QOL more slowly over time compared to men.


CONCLUSIONS
Reliance on denial as a coping strategy is associated with poorer physical and mental health-related QOL in an HIV-positive population, though participants who engaged in denial also displayed more rapid improvement in their QOL over time. Men and women displayed different rates of improvement in QOL, indicating a need for gender-based treatment approaches. Future research should examine the complex role of denial on change in QOL.
Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, 401 Quarry Road, Stanford, CA 94305-5718, USA. ckamen@stanford.edu
Charles
C
Kamen
Stacy
S
Taniguchi
Ami
A
Student
Eliza
E
Kienitz
Katherine
K
Giles
Christine
C
Khan
Susanne
S
Lee
Cheryl
C
Gore-Felton
Cheryl
C
Koopman
D000223:Adaptation, Psychological; D000328:Adult; D003717:Denial, Psychological; D005260:Female; D015658:HIV Infections / Q000188:drug therapy / Q000523:psychology*; D006305:Health Status Indicators; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D011594:Psychometrics; D011615:Psychotherapy, Group; D011788:Quality of Life / Q000523:psychology*; D012737:Sex Factors; D012944:Social Support; D013315:Stress, Psychological; D011795:Surveys and Questionnaires