Physical Activity and Immunity in HIV-Infected Individuals

The purpose of this study was to determine what relationship exists among physical activity levels and viral load and CD4+ cell count in HIV-infected individuals. Increased viral load is associated with disease progression and symptom severity. A convenience sample of 66 male and female subjects between the ages of 18 and 64 years of age (mean 399/8) was recruited from a hospital-based HIV/AIDS clinic. Components of PA were assessed for three continuous days using a mini-motion logger wrist actigraph. These components included mean PA level, and PA index and acceleration index. Pearson’s correlational analysis was used to test the strength of association between PA components and viral load or CD4+ cell count. A significant inverse relationship was found between mean PA level and viral load (p=0.047). An inverse relationship was also observed between PA index and viral load (p=0.0061). Neither mean PA nor PA index scores correlated with CD4+ cell counts. Acceleration index, a measure of PA intensity, showed no correlation to viral load or CD4+ cell counts. These findings suggest that increasing levels of physical activity might have beneficial effects on viral load in HIV-infected individuals

RACE DIFFERENCES IN CARDIOVASCULAR AND CORTISOL RESPONSES TO AN INTERPERSONAL CHALLENGE IN WOMEN WHO ARE FAMILY CAREGIVERS

Objectives: To examine race differences in psychosocial and psychophysiological responses to family caregiving. Design: Participants completed paper-andpencil surveys and were exposed to a laboratory- based interpersonal challenge that included a period of rest, an interpersonal challenge, and a period of recovery. Setting: A university research laboratory. Participants: Sixteen Caucasian and 12 African-American postmenopausal (64610 years) women who were caregivers to a family member with dementia. Measures: Psychosocial functioning included self-reported perceived stress, caregiver burden, social support, and caregiving meaning. Systolic and diastolic blood pressure (SBP,DBP) and heart rate (HR) were measured every two minutes during the rest, challenge, and recovery. Salivary cortisol was measured at rest and 15-minutes post-challenge. Results: There was a Race 3 Task interaction for SBP and HR but not DBP reactivity. African-American women showed greater reactivity than Caucasian women. The magnitude of this interaction was large. African-American women also reported greater caregiving from meaning than Caucasian women. In contrast, significantly more African Americans (58%) than Caucasians (14%) showed cortisol reactivity from rest to 15-minutes post-challenge. Conclusions: The differential pattern of physiologic responses is consistent with studies outside of the caregiving literature, and suggests that caregiving may be perceived as more effortful among Caucasian women and less controllable among African-American women

Physiological and Psychological Correlates of Fatigue in HIV Disease

Fatigue is a frequent symptom reported by persons living with HIV disease and one that affects all aspects of quality of life. To improve quality of care of persons with HIV disease, it is important to address all factors that contribute to fatigue. The purpose of this study was to determine the associations of physiological, psychological, and sociological factors with fatigue in an HIV-infected population. With Piper’s integrated fatigue model guiding selection, factors examined in this study were hemoglobin, hematocrit, CD4+ cell count, HIV-RNA viral load, total sleep time, sleep quality, daytime sleepiness, HIV-related symptoms, anxiety, depression, and perceived stress. The sample (N = 79) for this descriptive correlational study was recruited from a primary health care association in South Carolina and consisted of 42 (53.2%) HIV-infected women and 37 (46.8%) HIV-infected men between the ages of 24 and 63 years (x = 39.9, s = 7.9). Of the participants, 70 (90%) were African American, 5 (6%) were Caucasian, and 3 (4%) were Hispanic. Using Pearson’s r, significant relationships were observed between fatigue and sleep quality, daytime sleepiness, HIV-related symptoms, state anxiety, trait anxiety, depression, and perceived stress. Sleep quality (F5,65 = 12.02, P = 0.0009), state anxiety (F5,65 = 8.28, P = 0.0054), HIV-related symptoms (F5,65 = 4.87, P = 0.0308), and depression (F5,65 = 7.31, P = 0.0087) retained significance in a 3-step, backward stepwise elimination model and accounted for 67% of the variance in fatigue. These findings underscore the need for addressing psychosocial stressors and sleep quality in developing effective care for HIV-infected individuals who experience fatigue