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Examining Associations Between Cognitive-Affective Vulnerability and HIV Symptom Severity, Perceived Barriers to Treatment Adherence, and Viral Load Among HIV-Positive Adults

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Abstract

Background

Little research on symptom impairment and quality of life among HIV-positive (HIV+) individuals has attended to the potential role of cognitive-affective vulnerabilities. Emerging research indicates that emotion regulation (ER), anxiety sensitivity (AS), and distress tolerance (DT) are associated with a range of mental health outcomes and demonstrate meaningful relations to clinical outcomes in HIV+ individuals.

Purpose

In this investigation, we sought to concurrently examine these factors in relation HIV symptom severity, barriers to medication adherence, and disease viral load.

Method

Participants were 139 HIV+ individuals (34 female; age M = 48.2 years, SD = 8.1, 42 % Black) receiving outpatient HIV care and prescribed at least one antiretroviral medication. We used hierarchical regression analyses to concurrently examine ER, AS, and DT in relation to severity of HIV symptoms, barriers to medication adherence, and disease viral load.

Results

After accounting for alcohol use problems, cannabis dependence, gender, and education, AS was significantly associated with HIV symptom severity (β = .35, p < .01) whereas ER evidenced a trend relation (β = .19, p = .07). ER (β = .45, p < .01), but not AS or DT, was significantly related to barriers to medication adherence, above and beyond variance accounted for by covariates. Finally, ER evidenced a trend level relation to viral load (β = .21, p = .07), above and beyond variance accounted for by cannabis use.

Conclusion

Findings provide an extension of previous research, suggesting unique roles of cognitive-affective vulnerabilities in terms of HIV symptom severity, medication use barriers, and infection symptomatology, and inform the refinement of current treatments for HIV+ individuals so as to improve functioning.

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Acknowledgments

This research was supported by National Institute on Drug Abuse grants P50 DA009253, T32 DA007250 (Dr. Leyro), National Institutes of Health, Institutional (University of Texas) grant K12TR000370-07 (Dr. Vujanovic), Department of Veterans Affairs (VA) grant CSR&D CDA-2, and a California HIV/AIDS Research Program IDEA Award (163836) (Dr. Bonn-Miller)

Conflict of Interest

Dr. Leyro, Dr. Vujanovic, and Dr. Bonn-Miller declare that they have no conflict of interest.

Statement of Human and Animal Rights

Dr. Leyro, Dr. Vujanovic, and Dr. Bonn-Miller conformed to the Helsinki Declaration of 1975, as revised in 2000 and 2008, concerning human rights and informed consent, including following the correct procedures regarding the ethical treatment of humans in research.

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Authors and Affiliations

  1. Department of Psychology, Rutgers, The State University of New Jersey, Tillett Hall, 53 Avenue E, Piscataway, NJ, 08853, USA

    Teresa M. Leyro

  2. Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at Houston, Houston, TX, USA

    Anka A. Vujanovic

  3. Center for Innovation to Implementation, VA Palo Alto Health Care System, Palo Alto, CA, USA

    Marcel O. Bonn-Miller

  4. National Center for PTSD, VA Palo Alto Health Care System, Palo Alto, CA, USA

    Marcel O. Bonn-Miller

  5. Center of Excellence in Substance Abuse Treatment and Education, Philadelphia VAMC, Philadelphia, PA, USA

    Marcel O. Bonn-Miller

  6. Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA

    Marcel O. Bonn-Miller

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  1. Teresa M. Leyro
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  2. Anka A. Vujanovic
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  3. Marcel O. Bonn-Miller
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Correspondence to Teresa M. Leyro.

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Leyro, T.M., Vujanovic, A.A. & Bonn-Miller, M.O. Examining Associations Between Cognitive-Affective Vulnerability and HIV Symptom Severity, Perceived Barriers to Treatment Adherence, and Viral Load Among HIV-Positive Adults. Int.J. Behav. Med. 22, 139–148 (2015). https://doi.org/10.1007/s12529-014-9404-8

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