AIDS and Behavior

, Volume 16, Issue 8, pp 2144–2159

Stress and Coping in Women Living with HIV: A Meta-Analytic Review

Substantive Review

Abstract

To examine effects between stressors and coping mechanisms on behavioral health outcomes a meta-analysis was conducted using forty empirical articles which sampled 7,602 adult women living with HIV/AIDS in the U.S. (M = 36.3 years). Three independent reviewers conducted searches in abstract databases from 1997 to present day. Articles reporting effect sizes amongst psychosocial stressors and coping mechanisms with indices of behavioral/mental health were selected. The meta-analyses revealed that in a time frame characterized by the widespread availability of anti-retroviral medication, poor mental health outcomes were predicted, in a similar manner, by psychosocial stress and HIV/AIDS symptomology. Significant effects were also observed with functional impairment, though to a lesser degree. Coping by avoidance and social isolation predicted more severe mental health outcomes. Spirituality and positive reappraisal predicted greater psychological adaptation than did social support seeking. Despite advancements in anti-retroviral treatment for women, HIV/AIDS symptoms and acute and/or chronic psychosocial stress pose the same threat to behavioral and mental health. In the face of these stressors, positive reframing appears to promote psychological adaptation in a way which may lead to positive health outcomes in women living with HIV/AIDS.

Keywords

Stress Coping Women HIV AIDS Mental health Disease adjustment 

Resumen

En este meta-análisis se examinó el efecto que el estrés y los mecanismos de adaptación tienen sobre el ajuste a la enfermedad; se utilizaron cuarenta artículos empíricos que incluyeron un total de 7.602 mujeres adultas que sufrían de VIH/SIDA (Medad = 36,3 años). Tres revisores hicieron independientemente hicieron búsquedas en bases de datos de artículos publicados desde 1997 a la actualidad. Se escogieron artículos que describían el tamaño del efecto en el estrés psicosocial, en los mecanismos de adaptacion con índices de salud mental o conductual. Tanto el estrés psicosocial como la sintomatología de HIV/AIDS predijeron una inapropiada salud mental. En menor grado se observaron alteraciones en el funcionamiento. El enfrentarse a la enfermedad a través del aislamiento social y la evitación predijeron el desajuste en la salud mental de HIV/AIDS. La espiritualidad y reevaluación positiva predijeron mejor el afecto positivo que la búsqueda de apoyo social. A pesar de los avances en la terapia HAART, el estrés psicosocial agudo y crónico asociado a los síntomas de HIV/AIDS, continúa contribuyendo a la psicopatología y a la presencia de conductas de salud desviadas en mujeres con HIV/AIDS. Estas mujeres emplean una multitud de mecanismos de adaptación para amortiguar los efectos del estrés.

Palabras clave

Estrés Afrontamiento Mujeres VIH SIDA Salud mental Ajuste a la enfermedad Adaptación 

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© Springer Science+Business Media, LLC 2012

Authors and Affiliations

  1. 1.Department of PsychologyCharles E. Schmidt College of Science, Florida Atlantic UniversityDavieUSA

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