Kemeny M E, Dean L
Department of Psychiatry & Biobehavioral Sciences, University of California, Los Angeles 90024, USA.
AIDS Educ Prev. 1995;7(5 Suppl):36-47.
This study investigates the relationship between early AIDS-related bereavement and subsequent changes in CD4 T-cell levels and health over a three- to four-year follow-up period in 85 HIV positive gay men. In addition, two psychological responses to loss, grief, and depression were distinguished and used as predictors of changes in health following loss. Interview data collected each year was used to assess psychological, behavioral and health factors. Blood samples drawn yearly were used to assess CD4 T-cell levels. Results indicate that those who had experienced an AIDS-related bereavement event prior to entry into the study showed a more rapid loss of CD4 T-cells over time, controlling for age, initial health status, use of antiretrovirals, sedatives, recreational drugs, cigarettes, and alcohol as well as other potential confounding factors. CD4 loss-rate differences were observable by two years post-bereavement. In addition, grief reactions were distinguishable from depressive reactions. Grief reactions were unrelated to CD4 decline and symptom onset while aspects of depression, specifically self-reproach, were predictive of CD4 loss. These data suggest that bereavement may impact biological systems relevant to HIV progression and that distinguishing specific responses to loss may improve our understanding of these relationships.
本研究调查了85名HIV阳性男同性恋者在三到四年的随访期内，早期与艾滋病相关的丧亲之痛与随后CD4 T细胞水平变化及健康状况之间的关系。此外，区分了对丧失、悲伤和抑郁的两种心理反应，并将其用作丧失后健康变化的预测指标。每年收集的访谈数据用于评估心理、行为和健康因素。每年采集的血样用于评估CD4 T细胞水平。结果表明，在进入研究之前经历过与艾滋病相关丧亲事件的人，在控制了年龄、初始健康状况、抗逆转录病毒药物、镇静剂、消遣性药物、香烟和酒精以及其他潜在混杂因素后，随着时间的推移，CD4 T细胞的丧失速度更快。丧亲两年后可观察到CD4丧失率的差异。此外，悲伤反应与抑郁反应是可区分的。悲伤反应与CD4下降和症状发作无关，而抑郁的某些方面，特别是自我责备，可预测CD4丧失。这些数据表明，丧亲之痛可能会影响与HIV进展相关的生物系统，区分对丧失的特定反应可能会增进我们对这些关系的理解。
