AIDS and Behavior

, Volume 22, Issue 5, pp 1496–1502 | Cite as

Positive and Negative Self-Conscious Emotion and Transmission Risk Following HIV Diagnosis

  • Abigail W. Batchelder
  • Adam W. Carrico
  • Michael Acree
  • Frederick M. Hecht
  • Judith Tedlie Moskowitz
Original Paper
First Online:

Abstract

While negative emotions are associated with risk behaviors and risk avoidance among people with HIV, emerging evidence indicates that negative self-conscious emotions, those evoked by self-reflection or self-evaluation (e.g., shame, guilt, and embarrassment), may differentially influence health-risk behaviors by producing avoidance or, conversely, pro-social behaviors. Positive emotions are associated with beneficial health behaviors, and may account for inconsistent findings related to negative self-conscious emotions. Using multinomial logistic regression, we tested whether positive emotion moderated the relationships between negative emotion and negative self-conscious emotions and level of condomless sex risk: (1) seroconcordant; (2) serodiscordant with undetectable viral load; and (3) serodiscordant with detectable viral load [potentially amplified transmission (PAT)] among people recently diagnosed with HIV (n = 276). While positive emotion did not moderate the relationship between negative emotion and condomless sex, it did moderate the relationship between negative self-conscious emotion and PAT (AOR = 0.60; 95% CI 0.41, 0.87); high negative self-conscious and high positive emotion were associated with lower PAT risk. Acknowledgment of both positive and negative self-conscious emotion may reduce transmission risk behavior among people with HIV.

Keywords

Negative self-conscious emotion Positive emotion Shame HIV High-risk sex 
This is a preview of subscription content, log in to check access

Notes

Acknowledgements

The data used in this manuscript are taken from two studies of people recently diagnosed with HIV: an observational study to assess stress and coping (R01MH068170) and a clinical trial assessing a positive affect intervention (R01MH084723). This work was also supported by T32AT003997, K24MH093225, and K24 AT007827.

References

  1. 1.
    Centers for Disease Control. HIV in the United States: At a Glance (2015) http://www.cdc.gov/hiv/statistics/basics/ataglance.html. Accessed 16 July 2015.
  2. 2.
    Mayer KH, Skeer MR, O’Cleirigh C, Goshe BM, Safren SA. Factors associated with amplified HIV transmission behavior among American men who have sex with men engaged in care: implications for clinical providers. Ann Behav Med Publ Soc Behav Med. 2014;47(2):165–71.CrossRefGoogle Scholar
  3. 3.
    Crepaz N, Marks G. Are negative affective states associated with HIV sexual risk behaviors? A meta-analytic review. Health Psychol. 2001;20(4):291–9.CrossRefPubMedGoogle Scholar
  4. 4.
    Bancroft J, Janssen E, Strong D, Vukadinovic Z. The relation between mood and sexuality in gay men. Arch Sex Behav. 2003;32(3):231–42.CrossRefPubMedGoogle Scholar
  5. 5.
    Meyer IH. Prejudice, social stress, and mental health in lesbian, gay, and bisexual populations: conceptual issues and research evidence. Psychol Bull. 2003;129(5):674–97.CrossRefPubMedPubMedCentralGoogle Scholar
  6. 6.
    Mustanski B. The influence of state and trait affect on HIV risk behaviors: a daily diary study of MSM. Health Psychol Off J Div Health Psychol Am Psychol Assoc. 2007;26(5):618–26.Google Scholar
  7. 7.
    Houston E, Sandfort T, Dolezal C, Carballo-Diéguez A. Depressive symptoms among MSM who engage in bareback sex: does mood matter? AIDS Behav. 2012;16(8):2209–15.CrossRefPubMedPubMedCentralGoogle Scholar
  8. 8.
    Bousman CA, Cherner M, Ake C, Letendre S, Atkinson JH, Patterson TL, et al. Negative mood and sexual behavior among non-monogamous men who have sex with men in the context of methamphetamine and HIV. J Affect Disord. 2009;119(1–3):84–91.CrossRefPubMedPubMedCentralGoogle Scholar
  9. 9.
    Smoski MJ, Lynch TR, Rosenthal MZ, Cheavens JS, Chapman AL, Krishnan RR. Decision-making and risk aversion among depressive adults. J Behav Ther Exp Psychiatry. 2008;39(4):567–76.CrossRefPubMedPubMedCentralGoogle Scholar
  10. 10.
    Grov C, Golub SA, Mustanski B, Parsons JT. Sexual compulsivity, state affect, and sexual risk behavior in a daily diary study of gay and bisexual men. Psychol Addict Behav J Soc Psychol Addict Behav. 2010;24(3):487–97.CrossRefGoogle Scholar
  11. 11.
    Sarno EL, Mohr JJ, Rosenberger JG. Affect and condom use among men who have sex with men: a daily diary study. AIDS Behav. 2017;21(5):1429–43.CrossRefPubMedGoogle Scholar
  12. 12.
    Tangney J, Tracy J. Self-conscious emotions. In: Handbook of self and identity. 2nd ed. New York: Guilford Press; 2012. p. 446–479.Google Scholar
  13. 13.
    Bennett DS, Traub K, Mace L, Juarascio A, O’Hayer CV. Shame among people living with HIV: a literature review. AIDS Care. 2016;28(1):87–91.CrossRefPubMedGoogle Scholar
  14. 14.
    Tagney J, Tracy J. Self-conscious emotions. In: Handbook of self and identity. 2nd ed. New York: Guilford Press; 2012. p. 446–479.Google Scholar
  15. 15.
    Lickel B, Kushlev K, Savalei V, Matta S, Schmader T. Shame and the motivation to change the self. Emot Wash DC. 2014;14(6):1049–61.Google Scholar
  16. 16.
    Luoma JB, Kohlenberg BS, Hayes SC, Fletcher L. Slow and steady wins the race: a randomized clinical trial of acceptance and commitment therapy targeting shame in substance use disorders. J Consult Clin Psychol. 2012;80(1):43–53.CrossRefPubMedGoogle Scholar
  17. 17.
    Tangney JP, Wagner P, Gramzow R. Proneness to shame, proneness to guilt, and psychopathology. J Abnorm Psychol. 1992;101(3):469–78.CrossRefPubMedGoogle Scholar
  18. 18.
    Park M, Anderson JN, Christensen JL, Miller LC, Appleby PR, Read SJ. Young men’s shame about their desire for other men predicts risky sex and moderates the knowledge—self-efficacy link. Front Public Health. 2014;2:183.CrossRefPubMedPubMedCentralGoogle Scholar
  19. 19.
    Christensen JL, Miller LC, Appleby PR, Corsbie-Massay C, Godoy CG, Marsella SC, et al. Reducing shame in a game that predicts HIV risk reduction for young adult MSM: a randomized trial delivered nationally over the Web. J Int AIDS Soc. 2013;16(3 Suppl 2):18716.CrossRefPubMedPubMedCentralGoogle Scholar
  20. 20.
    Larsen JT, McGraw AP, Cacioppo JT. Can people feel happy and sad at the same time? J Pers Soc Psychol. 2001;81(4):684–96.CrossRefPubMedGoogle Scholar
  21. 21.
    Larsen JT, McGraw AP. Further evidence for mixed emotions. J Pers Soc Psychol. 2011;100(6):1095–110.CrossRefPubMedGoogle Scholar
  22. 22.
    Larsen JT, Green JD. Evidence for mixed feelings of happiness and sadness from brief moments in time. Cogn Emot. 2013;27(8):1469–77.CrossRefPubMedGoogle Scholar
  23. 23.
    Davidson Richard J. The neuropsychology of emotion and affective style. In: Lewis M, Haviland-Jones JM, Barrett LF, editors. Handbook of emotions. New York: The Guilford Press; 1993. p. 143–54.Google Scholar
  24. 24.
    Watson D, Wiese D, Vaidya J, Tellegen A. The two general activation systems of affect: structural findings, evolutionary considerations, and psychobiological evidence. J Pers Soc Psychol. 1999;76(5):820–38.CrossRefGoogle Scholar
  25. 25.
    Carver CS, Scheier MF. Origins and functions of positive and negative affect: a control-process view. Psychol Rev. 1990;97(1):19–35.CrossRefGoogle Scholar
  26. 26.
    Clore GL. Why emotions are felt. In: Ekman P, Davidson R, editors. The nature of emotion: fundamental questions. New York: Oxford University Press; 1994. p. 103–11.Google Scholar
  27. 27.
    Folkman S, Moskowitz JT. Positive affect and the other side of coping. Am Psychol. 2000;55(6):647–54.CrossRefPubMedGoogle Scholar
  28. 28.
    Fredrickson BL. What good are positive emotions? Rev Gen Psychol. 1998;2(3):300–19.CrossRefPubMedPubMedCentralGoogle Scholar
  29. 29.
    Isen AM. Positive affect, cognitive processes, and social behavior. In: Advances in experimental social psychology. Elsevier; 1987. p. 203–253. http://linkinghub.elsevier.com/retrieve/pii/S0065260108604153. Accessed 11 Aug 2017.
  30. 30.
    DeSteno D, Gross JJ, Kubzansky L. Affective science and health: the importance of emotion and emotion regulation. Health Psychol Off J Div Health Psychol Am Psychol Assoc. 2013;32(5):474–86.Google Scholar
  31. 31.
    Baumeister RF, Bratslavsky E, Muraven M, Tice DM. Ego depletion: is the active self a limited resource? J Pers Soc Psychol. 1998;74(5):1252–65.CrossRefPubMedGoogle Scholar
  32. 32.
    Fredrickson BL. The role of positive emotions in positive psychology. The broaden-and-build theory of positive emotions. Am Psychol. 2001;56(3):218–26.CrossRefPubMedPubMedCentralGoogle Scholar
  33. 33.
    Dieffenbach CW, Fauci AS. Universal voluntary testing and treatment for prevention of HIV transmission. JAMA. 2009;301(22):2380–2.CrossRefPubMedGoogle Scholar
  34. 34.
    Carrico AW, Moskowitz JT. Positive affect promotes engagement in care after HIV diagnosis. Health Psychol Off J Div Health Psychol Am Psychol Assoc. 2014;33(7):686–9.Google Scholar
  35. 35.
    Hult JR, Wrubel J, Bränström R, Acree M, Moskowitz JT. Disclosure and nondisclosure among people newly diagnosed with HIV: an analysis from a stress and coping perspective. AIDS Patient Care STDs. 2012;26(3):181–90.CrossRefPubMedPubMedCentralGoogle Scholar
  36. 36.
    Moskowitz JT, Wrubel J, Hult JR, Maurer S, Acree M. Illness appraisals and depression in the first year after HIV diagnosis. PLoS ONE. 2013;8(10):e78904.CrossRefPubMedPubMedCentralGoogle Scholar
  37. 37.
    Moskowitz JT, Carrico AW, Duncan LG, Cohn MA, Cheung EO, Batchelder A, et al. Randomized controlled trial of a positive affect intervention for people newly diagnosed with HIV. J Consult Clin Psychol. 2017;85(5):409–23.CrossRefPubMedGoogle Scholar
  38. 38.
    Fredrickson BL, Tugade MM, Waugh CE, Larkin GR. What good are positive emotions in crises? A prospective study of resilience and emotions following the terrorist attacks on the United States on September 11th, 2001. J Pers Soc Psychol. 2003;84(2):365–76.CrossRefPubMedPubMedCentralGoogle Scholar
  39. 39.
    Carrico AW, Johnson MO, Moskowitz JT, Neilands TB, Morin SF, Charlebois ED, et al. Affect regulation, stimulant use, and viral load among HIV-positive persons on anti-retroviral therapy. Psychosom Med. 2007;69(8):785–92.CrossRefPubMedGoogle Scholar
  40. 40.
    Aiken L, West S. Multiple Regression: Testing and interpreting interactions. Newbury Park: Sage; 1991.Google Scholar
  41. 41.
    Leith KP, Baumeister RF. Why do bad moods increase self-defeating behavior? Emotion, risk taking, and self-regulation. J Pers Soc Psychol. 1996;71(6):1250–67.CrossRefPubMedGoogle Scholar
  42. 42.
    Quoidbach J, Gruber J, Mikolajczak M, Kogan A, Kotsou I, Norton MI. Emodiversity and the emotional ecosystem. J Exp Psychol Gen. 2014;143(6):2057–66.CrossRefPubMedGoogle Scholar
  43. 43.
    Tugade MM, Fredrickson BL, Barrett LF. Psychological resilience and positive emotional granularity: examining the benefits of positive emotions on coping and health. J Pers. 2004;72(6):1161–90.CrossRefPubMedPubMedCentralGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2017

Authors and Affiliations

  • Abigail W. Batchelder
    • 1
    • 2
  • Adam W. Carrico
    • 3
  • Michael Acree
    • 2
  • Frederick M. Hecht
    • 2
  • Judith Tedlie Moskowitz
    • 2
    • 4
  1. 1.Department of PsychiatryMassachusetts General Hospital/Harvard Medical SchoolBostonUSA
  2. 2.Department of Medicine, Osher Center for Integrative MedicineUniversity of CaliforniaSan FranciscoUSA
  3. 3.Department of Public Health Sciences, Division of Prevention Science & Community HealthUniversity of MiamiCoral GablesUSA
  4. 4.Department of Medical School Sciences, Feinberg School of Medicine, Osher Center for Integrative MedicineNorthwestern UniversityChicagoUSA

Personalised recommendations