Researchers coached people recently diagnosed with HIV to practice skills to help them experience more positive emotions. Afterward, less of the virus showed up in their blood and they used fewer antidepressants, the study shows.
“Even in the midst of this stressful experience of testing positive for HIV, coaching people to feel happy, calm, and satisfied—what we call positive affect—appears to influence important health outcomes,” says Judith Moskowitz, professor of medical social sciences and director of research at the Osher Center for Integrative Medicine at Northwestern University Feinberg School of Medicine.
Researchers believe this is the first test of a positive emotion intervention in people newly diagnosed with HIV. The intervention could be promising for people in the initial stages of adjustment to any serious chronic illness, according to the study in the Journal of Consulting and Clinical Psychology.
The HIV study is part of a larger body of positive affect research, Moskowitz says. She is also studying the health effects of teaching the skills to individuals with type 2 diabetes, women with metastatic breast cancer, and caregivers of dementia patients.
For the HIV study, which was based in San Francisco, 80 participants (primarily men) learned a set of skills over five weekly sessions to help them experience more positive emotions. Another 79 participants were in the control group. Skills were chosen based on evidence that show they increase positive emotions. They include:
- Recognize a positive event each day.
- Savor that positive event and log it in a journal or tell someone about it.
- Start a daily gratitude journal.
- List a personal strength each day and note how you used it recently.
- Set an attainable goal each day and note your progress.
- Report a relatively minor stressor each day, then list ways to positively reappraise it. This can lead to increased positive affect in the face of stress.
- Practice a small act of kindness and understand that it can have a big impact on positive emotion.
- Practice mindfulness with a daily 10-minute breathing exercise, concentrating on the breath.
Fifteen months after the interventions, 91 percent of those who took part had a suppressed viral load compared to 76 percent of the control group. In addition to the potential benefit of a lower viral load on the infected person, there may be public health benefits, Moskowitz says.
“From a public health perspective, that is potentially huge for prevention of HIV. HIV is less likely to be transmitted with a low viral load. To have a difference like that is amazing.”
The reduced viral load could be because of a stronger immune system. Observational studies in people living with HIV have shown positive emotion is related to a higher CD4 count (an indicator of less HIV-related damage to the immune system). Or, the reduced viral load may be the result of participants’ better adherence to their antiretroviral drug therapy, which generally leads to a suppressed or undetectable viral load.
The positive emotion intervention also improved mental health. At baseline, about 17 percent of the control group and intervention group reported being on antidepressants. Fifteen month later, the intervention group was still at 17 percent but the control group’s antidepressant use rose to 35 percent.
“The group that learned coping skills did not increase antidepressant use, whereas overall the control group increased its antidepressant use,” Moskowitz says. Further, the intervention group was significantly less likely to have repeating, intrusive thoughts about HIV.
The National Institute of Mental Health and the Third Coast Center for AIDS Research, all of the National Institutes of Health, funded the study.
Source: Northwestern University