Livingston I L
J Natl Med Assoc. 1988 Jan;80(1):49-59.
Acquired immune deficiency syndrome (AIDS) is perhaps the most serious communicable public-health disease of modern society. The human and societal devastation associated with this disease is tremendous. To date, a retrovirus (HTLV-III) has been implicated in the etiology of AIDS. There remains several critical questions, however, that only a more eclectic approach, certainly with a social science input, can more adequately address. Such questions have to deal with, for example, why are there differential out-comes regarding initiation, progress, and severity of AIDS?Realizing this need, this paper argues for the possible co-factor contribution of stress to host immune suppression and, ultimately, host susceptibility to the AIDS virus and its associated outcomes. A conceptual sociopsychophysiologic model of the entire stress process, ie, from onset, reaction up to and including effect, is presented and discussed. Within the context of the model, stress is viewed as a physiologic reaction and stressors are viewed as initiators of the stress process. The possible stress-AIDS experience is discussed using the model as a conceptual guiding tool. The paper concludes with the need for health educators to educate the general public, at-risk groups, and the medical and associated professions about the nature of stress, or in short, how best to cope with and manage stress within the context of available resources.
获得性免疫缺陷综合征（艾滋病）或许是现代社会最严重的传染性公共卫生疾病。与这种疾病相关的对人类和社会的破坏是巨大的。迄今为止，一种逆转录病毒（人类嗜T淋巴细胞病毒III型）被认为与艾滋病的病因有关。然而，仍然存在几个关键问题，只有采用更兼收并蓄的方法，当然包括社会科学的投入，才能更充分地解决。这些问题必须涉及，例如，为什么在艾滋病的发病、进展和严重程度方面存在不同的结果？认识到这一需求，本文认为压力可能作为一种辅助因素导致宿主免疫抑制，最终导致宿主对艾滋病病毒及其相关后果易感。本文提出并讨论了一个关于整个压力过程的概念性社会心理生理模型，即从压力的产生、反应到包括其影响。在该模型的背景下，压力被视为一种生理反应，压力源被视为压力过程的引发因素。利用该模型作为概念性指导工具，讨论了压力与艾滋病经历之间的可能关系。本文最后指出，健康教育工作者有必要向普通公众、高危人群以及医学和相关专业人员宣传压力的本质，简而言之，就是在现有资源的背景下如何最好地应对和管理压力。
