SUNY Downstate faculty Dr. Tracey Wilson, Dr. Jeremy Weedon, and colleagues assessed the relationship between positive affect and viral suppression in women enrolled in the Women’s Interagency HIV Study. Among 995 women with HIV infection who were on HIV antiretroviral therapy, self-reported positive affect was measured over two, six-month waves of data collection. Viral load suppression, defined as plasma HIV-1 RNA <200 copies/mL, was measured at a third wave. Positive and negative affect were measured using subscales of the CES-D. Thirty-six percent of the women in the sample were classified as having higher positive affect. After adjusting for covariates and their interactions (negative affect, Wave 1 viral suppression, antiretroviral therapy adherence, study site, recruitment cohort, substance use, heavy drinking, relationship status, interpersonal difficulties, and demographics), a statistically significant interaction was detected between negative affect, positive affect and viral suppression. The association between positive affect and viral suppression differed based on the quartile value of negative affect. For those reporting no negative affect, the AOR for positive affect and viral suppression was 2.41 (95 percent CI: 1.35, 4.31); at a negative affect score of 2, the AOR was 1.44 (95 percent CI:0.87, 2.36); and at a negative affect score of 5.5, the AOR was 0.58 (95 percent CI: 0.24, 1.42). The investigators concluded that positive affect is associated with viral control under conditions of lower negative affect. They suggest that should future research identify a causal mechanism for the influence of positive affect on viral suppression, the development of interventions designed to promote and sustain positive affect could complement existing HIV clinical and mental health screening and treatment programs.
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