Fatores psicossociais e progressão da infecção por HIV/AIDS: possíveis associações

Abstract

Psychoneuroimmunology has been defined as the study about the interaction between behavior, neuroendocrine mechanisms and immunological processes. Different evidences have pointed correlations between behavior and psychosocial factors such as depression, anxiety, stress, quality of life, religiosity/spirituality, neuroendocrine mechanisms, immunological system and changes in HIV/AIDS progression. The aim of the present study was to explore the association between psychosocial variables, lymphocytes T CD4 levels, and viral load in a population of HIV seropositive, emphasizing the emotional, behavioral and social factors associated with immunosuppression and viral replication. The sample consisted of 197 HIV seropositive, attending a public program of sexuality transmitted diseases of Juiz de Fora/MG (Brazil) taking antiretroviral medicine for at least six months. Participants were divided in 2 groups: Group A (CD4 > 500) and Group B (CD4 ≤ 500). Levels of depression, anxiety, stress, quality of life, religious and spiritual aspects, CD4 T lymphocytes and viral load were compared. Data were tabulated and analyzed applying different statistical strategies: Odds Ratio between categorical variables and AIDS diagnosis, analyses of the differences between groups (Mann Whitney test), and analyses to verify the correlation between continuous variables (ρ de Spearman e r de Pearson). Key results pointed significant positive correlations between the variables of R/E commitment and living with HIV (ρ = 0.338; p = 0.05), R/E commitment and age (ρ = 0.310; p = 0.04), R/E self-assessment and living with HIV (ρ = 0.409, p = 0.01). And significant negative correlations between daily spiritual experiences and viral load (ρ = - 0.287; p = 0.06), R/E values and beliefs and CD4 (ρ = - 0.326; p = 0.03). In general, our results pointed that religious/spiritual variables such as R/E commitment, R/E self-assessment, daily spiritual experiences, and R/E values and beliefs, might be associated with changes in lymphocytes T CD4 and viral load levels among HIV seropositive people. These evidences indicate the relevance of future scientific investigations about possible reciprocal relations between religious/spiritual aspects and HIV/AIDS disease progression.