Stress and immunity in individuals at risk for aids

We have examined psychosocial and immune system stress responses in gay men before and after their notification of human immunodeficiency virus (HIV‐1) status and as a consequence of stress management intervention procedures. Prior to notification, early stage, asymptomatic, seropositive men displayed compromised immunity as evidenced by significant decreases in CD4+ cell number, the helper subset (CD29 + CD4 +), CD4 +/CD8 + ratio, and lymphocyte responses to mitogens. Prior to diagnosis, both seronegative and seropositive men revealed suppression of NK cell cytotoxicity and mitogen responsivity relative to matched laboratory control subjects not awaiting diagnosis. Immune suppression in these seronegative men disappeared after diagnosis, indicating its relationship to anticipation of serostatus notification. We also found that a 10‐week program of aerobic exercise or psychosocial stress management buffered the psychological impact of notification of seropositivity. The aerobic exercise program produced a significant increase in CD4+ cells for seronegatives and a smaller increase approaching significance for seropositives. The psychosocial intervention, which included relaxation training and cognitive stress management, produced significant increases in CD4+ and NKH.1 + for seronegatives and CD45R + CD4 + cell number and mitogen responsivity for seropositives. We are assessing our interventions as tools for retarding immune deterioration and disease progression in HIV‐1 seropositive individuals.