Associations of psychological and physiological stress among HIV-infected individuals

People living with HIV/AIDS (PLWHA) often experience elevated emotional and physiological stressors including HIV, antiretrovirals, & social/economic conditions. Chronic stress has shown to reduce immune function, increasing the risk of opportunistic infections and disease progression. Additionally, it has been proposed that elevated perceived and physiological stress levels exacerbate HIV-related symptoms. Purpose: To test the associations of HIV-related symptoms, symptom distress, perceived stress, and physiological stress in PLWHA. Methods: Data were used from a study in which all subjects who completed data collection prior to randomization were included for data analysis (N = 113). Data packets consisted of questionnaires including the perceived stress scale (PSS), symptom distress scale (SDS), and Spielberger's state anxiety inventory (SAI). Resting salivary cortisol (CORT), a marker of physiological stress was collected at wake, wake +1 hr, and wake +2 hr as well (n = 14). Pearson's correlation was used to test the associations among variables. Results: Associations were observed among PSS and SAI (r = 0.517, p < 0.001), PSS and SDS symptoms (r = 0.382, p < 0.001), as well as PSS and symptom distress (r = 0.346, p < 0.001). Further results showed significant correlations with CORT and symptoms (r = 0.560, p = 0.037), but not CORT and PSS or CORT and symptom distress. Conclusion: These data indicate that physiological and perceived stress are associated strongly with HIV-related symptoms. Only perceived stress was associated with symptom distress. Further, there was not an association between perceived stress and physiological stress.