Positive affect promotes engagement in care after HIV diagnosis.
OBJECTIVE
Revised Stress and Coping Theory proposes that positive affect serves adaptive functions, and its beneficial effects are heightened during stressful periods. This study examined the prospective relationship between positive affect and engagement in care during the 18 months after a HIV seropositive diagnosis.


METHODS
The Coping, HIV, and Affect Interview (CHAI) cohort study enrolled 153 individuals who had recently received a HIV seropositive diagnosis. Using logistic and linear regression, baseline positive affect was examined as a predictor of linkage to HIV care, antiretroviral therapy (ART) persistence (i.e., starting ART and remaining on it during subsequent follow-up assessments), and mean log₁₀ HIV viral load over follow-up.


RESULTS
After controlling for education, T-helper (CD4+) count, HIV viral load, and negative affect, higher baseline positive affect independently predicted increased odds of linkage to HIV care at 3 months postdiagnosis (adjusted OR [AOR] = 1.10; 95% CI = 1.01-1.21) and ART persistence over the 18-month follow-up period (AOR = 1.08; 95% CI = 1.01-1.16). Positive affect was not directly associated with lower mean HIV viral load over follow-up. However, one standard deviation higher positive affect indirectly predicted 6.7% lower HIV viral load via greater odds of ART persistence (βindirect = -0.18, p < .05).


CONCLUSIONS
Greater positive affect predicts linkage to HIV care and ART persistence. ART persistence, in turn, is associated with lower HIV viral load. Clinical research is needed to examine whether interventions designed to enhance positive affect can boost the effectiveness of HIV treatment as prevention.
Department of Community Health Systems, School of Nursing.
Adam W
AW
Carrico
Osher Center for Integrative Medicine, University of California.
Judith Tedlie
JT
Moskowitz
D000328:Adult; D000339:Affect; D019380:Anti-HIV Agents / Q000627:therapeutic use; D005260:Female; D005500:Follow-Up Studies; D015658:HIV Infections / Q000188:drug therapy*; D006679:HIV Seropositivity / Q000175:diagnosis* / Q000523:psychology*; D006801:Humans; D016014:Linear Models; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance / Q000523:psychology* / Q000706:statistics & numerical data; D011446:Prospective Studies; D016896:Treatment Outcome; D019562:Viral Load / Q000706:statistics & numerical data
D019380:Anti-HIV Agents