EMOTIONAL DISTRESS

Emotional Distress In African American Women With HIV

Emotional Distress In African American Women With HIV

Introduction

This study evaluated African American female drug users (aged 18-59 years) participating in an HIV intervention and with higher levels of emotional distress, specifically symptoms of depression and anxiety, reduced HIV risk behaviors to a lesser extent than those with lower levels of emotional distress. Participants were recruited between June 1998 and January 2001 from inner-city Atlanta neighborhoods and were randomly assigned to one of two enhanced gender-specific and culturally specific HIV intervention conditions or to the NIDA standard condition. Participants were interviewed at baseline, post-intervention and at 6-month follow-up with a structured questionnaire including information on sociodemographics, sexual and drug-using behavior, and psychosocial characteristics.(Garssen,1999)

Despite a significant decline in symptoms of emotional distress during the study period, the women in this sample reported high levels of depressive and anxiety symptoms at baseline and 6-month follow-up. Higher levels of emotional distress were positively associated with post-intervention sexual and drug-taking risk. Women in both enhanced intervention conditions reduced their sexual and drug-taking risks more than women in the standard intervention. Those in the motivation intervention arm experienced a greater reduction in depressive symptoms, accompanied by a greater reduction in sexual risk behavior. Findings suggest the need for effective interventions and mental health resources among subgroups of high-risk women who may be most resistant to behavioral change.(O'Leary,1999)

Discussion

Garssen(1999) focused on emotional responses to religion as powerful forces for the maintenance of social forms. Weber argued that capitalism arose partially because of ubiquitous emotional responses encountered by new Protestants during the Reformation. Experiencing anxiety over their predetermined status as saved or damned, individuals strove to acquire external accoutrements of material success that might signal a favored status. Once capitalism was in place, Weber argued that rational bureaucracy required emotional management to isolate emotional response to private rather than formal institutional spheres.(Ader,2001)

The best way to test the efficacy of behavioral interventions at increasing immunity and improving health is to examine diseases characterized by immunodeficiency. The progression of HIV is marked by decreases in levels of CD4 cells, and demonstrating that behavioral interventions result in slower progression or an increase in CD4 cell number would be a strong argument for the utility of these interventions. Unfortunately, results of studies examining whether behavioral interventions enhance immune functioning in HIV-positive individuals have been equivocal. Several studies have employed the use of a variety of interventions in an attempt to improve immune functioning, with limited success. Early research failed to produce increased immune functioning in men with HIV who received training in relaxation techniques and stress management skills. Although intervention recipients reported less distress, less depression, and increased quality of life, there were no differences in immune measures or disease-related symptoms between intervention and control groups. However, recent research has proved more promising.(Ader,2001)

Over the past decade, Antoni and colleagues have conducted several large-scale studies examining the effect of a variety of behavioral interventions on immune functioning in HIV-positive ...